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Updated: Jan 28, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

Rescue high frequency ventilation for congenital diaphragmatic hernia.

M A Attar¹, R E Dechert², S M Donn¹

¹Department of Pediatrics and Communicable Diseases, Division of Neonatal-Perinatal Medicine, Ann Arbor, Michigan, USA.

Journal of Neonatal-Perinatal Medicine

|March 5, 2019

Summary

This summary is machine-generated.

High-frequency ventilation (HFV) improved gas exchange in newborns with congenital diaphragmatic hernia (CDH). High-frequency oscillatory ventilation (HFOV) resulted in higher mean airway pressure than high-frequency jet ventilation (HFJV).

Keywords:

Hemodynamic neonates rescue respiratory failure surgery

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Area of Science:

Neonatal Medicine
Pediatric Critical Care
Respiratory Physiology

Background:

Congenital diaphragmatic hernia (CDH) poses significant respiratory challenges in newborns.
Conventional mechanical ventilation (CV) may be insufficient for severe CDH cases.
High-frequency ventilation (HFV) strategies, including HFJV and HFOV, offer alternative rescue therapies.

Purpose of the Study:

To compare the effects of HFJV and HFOV on pulmonary gas exchange and ventilator settings in CDH newborns.
To evaluate the transition from CV to HFV in this vulnerable patient population.

Main Methods:

Retrospective review of CDH patients (2006-2015) rescued with HFV before surgery.
Comparison of mean airway pressure (Pāw) and arterial blood gases (PaCO2, FiO2, PaO2) during CV and early HFV.
Statistical analysis using composite repeated measures to assess longitudinal and intergroup differences.

Main Results:

Twenty-seven neonates (16 HFJV, 11 HFOV) were analyzed, with no significant differences in gestational age or birth weight.
HFV significantly improved ventilation in both groups.
While PaCO2 decrease rates were similar, HFOV demonstrated a significantly greater increase in Pāw compared to HFJV.

Conclusions:

HFV effectively improves ventilation in newborns with CDH.
HFJV provides adequate ventilation support with a lower Pāw compared to HFOV in CDH patients.
These findings inform ventilator strategy selection for CDH rescue.