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Updated: Oct 14, 2025

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Published on: April 8, 2022
Lung Recruitment Using High-Frequency Oscillation Volume Guarantee in Preterm Infants with Evolving Bronchopulmonary
Linda Gai Rui Chen1, Po-Yin Cheung1,2, Brenda Hiu Yan Law1,2
1Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Insights
Lung recruitment maneuvers (LRMs) in preterm infants on high-frequency oscillation with volume guarantee (HFO-VG) did not show sustained improvements in oxygenation or ventilation, despite initial SpO2/FiO2 increases.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Critical Care
Background:
- Stepwise lung recruitment maneuvers (LRMs) are utilized in ventilated preterm infants.
- The efficacy of LRMs in conjunction with high-frequency oscillation with volume guarantee (HFO-VG) remains understudied.
Background:
Stepwise lung recruitment maneuvers (LRMs) may be used in ventilated preterm infants. However, its use in high-frequency oscillation with volume guarantee (HFO-VG) is not well studied.
Methods:
Preterm infants treated with HFO-VG who had LRMs were identified. Patient and respiratory parameters were recorded.
Results:
Ten infants, median GA 25+6 (IQR 24+2-27+0) weeks, and 21 LRMs were identified. LRMs were performed at a median age of 26 days, with a starting MAP of 16 (14-17) cm H2O and the highest MAP of 23.5 (22.0-24.8) cm H2O. Most (76%) resulted in immediate improved SpO2/FiO2. There were no sustained differences in median oxygen saturation index (8.4 vs. 9, p = 0.09), SpO2/FiO2 (1.8 vs. 1.8, p = 0.8), ∆P (21 vs. 23, p = 0.64), or transcutaneous CO2 (58 vs. 60, p = 0.84) in 24 h before and after LRMs.
Conclusions:
In preterm infants with evolving bronchopulmonary dysplasia, LRMs on HFO-VG did not result in sustained improvement to oxygenation or ventilation.
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