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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
04:46

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation

Published on: January 17, 2011

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First intention high-frequency jet ventilation for periviable infants

Timothy G Elgin1, Amy H Stanford, Jonathan M Klein

  • 1Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA.

Current Opinion in Pediatrics
|January 16, 2022
PubMed

Insights

High-frequency jet ventilation (HFJV) is a critical tool for periviable infants. Recent studies show HFJV is effective for infants under 750g, even with small endotracheal tubes, despite limited trials.

Area of Science:

  • Neonatology
  • Pediatric Critical Care
  • Respiratory Support

Background:

  • Ventilating periviable infants (22-23 weeks gestation) presents significant challenges.
  • High-frequency jet ventilation (HFJV) is a specialized technique used in neonatology.

Purpose of the Study:

  • To review evidence on using first intention HFJV for infants near the limits of viability.
  • To analyze pulmonary fetal development and HFJV strategies, including those from early trials.

Main Methods:

  • Review of existing literature and randomized trials on HFJV in periviable infants.
  • Analysis of a recent retrospective observational cohort trial on HFJV efficacy.

Main Results:

  • A lack of recent randomized controlled trials (RCTs) exists, with none in the past 25 years.
  • A recent trial demonstrated HFJV efficacy in infants <750g, including those with 2.0-mm endotracheal tubes.

Conclusions:

  • The scarcity of recent RCTs fuels ongoing debate regarding first intention HFJV.
  • This review presents an experienced center's HFJV strategy for infants <24 weeks gestation, highlighting the need for further research.
Abstract

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