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Updated: Oct 6, 2025
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
Summary
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.
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