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Noninvasive High-Frequency Oscillatory Ventilation: A Retrospective Chart Review
Yaser A H Ali1, Mary M Seshia1, Ebtihal Ali1
1Department of Pediatrics and Child Health, Section of Neonatology, University of Manitoba, Winnipeg, Manitoba, Canada.
American Journal of Perinatology
|October 19, 2020
Summary
Nasal high-frequency oscillatory ventilation (NHFOV) is feasible for preterm infants post-extubation, reducing apnea. Further trials are needed to confirm its efficacy and safety in preventing reintubation.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Critical Care
Background:
- Premature infants often require respiratory support post-extubation.
- Noninvasive ventilation strategies are crucial for preventing reintubation in this vulnerable population.
- Nasal high-frequency oscillatory ventilation (NHFOV) is an emerging technique for neonatal respiratory support.
Purpose of the Study:
- To evaluate the feasibility of NHFOV in preventing reintubation in preterm infants.
- To assess NHFOV's effectiveness as a prophylactic or rescue therapy after extubation.
- To identify potential benefits and areas for further research regarding NHFOV.
Main Methods:
- Retrospective cohort study of preterm infants receiving NHFOV in a neonatal intensive care unit.
- NHFOV was administered as primary prophylaxis or rescue therapy post-extubation.
- Data collected included reintubation rates, apnea frequency, PCO2 levels, and FiO2 requirements.
Main Results:
- NHFOV was used on 32 occasions in 27 preterm infants.
- Successful ventilation with NHFOV occurred in 69% of cases; 31% required reintubation within 72 hours.
- NHFOV significantly reduced the number of apneas but did not alter PCO2 levels or oxygen requirements.
Conclusions:
- NHFOV is a feasible noninvasive ventilation method for preterm infants post-extubation, acting as prophylaxis or rescue therapy.
- The use of NHFOV is associated with a decrease in apnea episodes.
- A randomized controlled trial is necessary to establish definitive indications, clinical outcomes, and safety of NHFOV.
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