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Effect of high-frequency oscillatory ventilation combined with volume guarantee on preterm infants with hypoxic

Lih-Ju Chen1,2, Jia-Yuh Chen1,2

  • 1Department of Pediatrics, Changhua Christian Children's Hospital, Changhua, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA
|November 7, 2019
PubMed

Insights

Volume guarantee (VG) with high-frequency oscillatory ventilation (HFOV) improved outcomes for preterm infants with hypoxic respiratory failure (HRF). This approach reduced the combined risk of death or bronchopulmonary dysplasia and episodes of hypercarbia compared to HFOV alone.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Hypoxic respiratory failure (HRF) is a critical condition in preterm infants.
  • Conventional mechanical ventilation (CMV) may be insufficient for severe HRF.
  • High-frequency oscillatory ventilation (HFOV) is an alternative but can have limitations.

Purpose of the Study:

  • To evaluate the impact of adding volume guarantee (VG) to HFOV.
  • To compare HFOV with VG versus HFOV alone in preterm infants with HRF.
  • To assess the effect on mortality, bronchopulmonary dysplasia (BPD), and hypercarbia.

Main Methods:

  • A comparative study of 52 preterm infants with HRF.
  • Infants were refractory to CMV.
  • Group 1: HFOV alone (n=34) as rescue therapy.
  • Group 2: HFOV combined with VG (n=18) as rescue therapy.

Main Results:

  • HFOV with VG significantly reduced the combined outcome of death or BPD (p = 0.017).
  • HFOV with VG also significantly decreased episodes of hypercarbia (p = 0.010).
  • These benefits were observed compared to HFOV alone.

Conclusions:

  • Combining HFOV with VG is beneficial for preterm infants with HRF.
  • This strategy improves survival and reduces lung injury (BPD).
  • VG-HFOV effectively manages hypercarbia in this vulnerable population.
Abstract

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