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High-frequency ventilation and conventional mechanical ventilation in newborn babies with respiratory distress
A Pardou1, D Vermeylen, M F Muller
1Department of Neonatal Medicine, Erasmus Hospital, Free University of Brussels, Belgium.
Objective:
Morbidity and mortality remain high amongst babies ventilated for a respiratory distress syndrome (RDS). Whether newly developed ventilators allowing high frequency ventilation such as high frequency flow interrupted ventilation (HFFIV) could decrease the morbidity and the mortality was investigated in a randomized study.
Design:
Preterm babies weighing < or = 1800 g suffering from RDS and ventilated by conventional mechanical ventilation (CMV) were randomized to be further ventilated either by CMV (group CMV) or by HFFIV (group HFFIV) when peak inspiratory pressure (PIP) on CMV was > or = 20 cmH2O.
Setting:
The study was undertaken in the neonatal intensive care unit of the Erasmus Hospital.
Patients:
24 patients entered into the investigation and were randomized but 2 patients were removed from the study because the switch over to HFFIV failed. Eight of the 12 CMV patients and 5 of the 10 HFFIV patients completed the study.
Measurements And Results:
Clinical variables, blood gas analysis and ventilatory variables were looked at. There were no differences in mortality, in incidence of air leaks and pulmonary complications or in blood gas analysis. Bronchopulmonary dysplasia was not decreased by the use of HFFIV.
Conclusion:
It is concluded that HFFIV is safe although it offers no concrete advantages over CMV when applied as we did in a low pressure approach.