[High-frequency oscillatory ventilation of newborn infants]

Ventilator-induced lung injuries remain an important factor regarding morbidity and mortality in newborns requiring assisted ventilation. Numerous different modes of ventilation have been tried without achieving recognition. High-frequency oscillatory ventilation (HFO) is a new mode of ventilation which employs active inspiration and expiration at frequencies up to 20 Hz with a tidal volume below dead space. Progression of severe respiratory distress syndrome may be reduced by applying early HFO beside modern treatment modes. It has been demonstrated that immediate initial treatment of premature babies with high tidal volumes can cause lung damage. Clinical studies of HFO indicate, that it is possible to improve oxygenation, reduce short-term mortality, surfactant redosing, ventilator-time, use of extra corporeal membrane oxygenation (ECMO) and costs of hospitalization. Morbidity related to lung injury and cerebral damage is apparently unchanged compared to conventional mechanical ventilation. The use of HFO in milder cases awaits further clinical studies.