Efficacy of early piston-type high-frequency oscillatory ventilation in infants with respiratory distress syndrome

Citation
T. Sakai et al., Efficacy of early piston-type high-frequency oscillatory ventilation in infants with respiratory distress syndrome, PEDIAT PULM, 32(2), 2001, pp. 168-174
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics
Journal title
PEDIATRIC PULMONOLOGY
ISSN journal
8755-6863 → ACNP
Volume
32
Issue
2
Year of publication
2001
Pages
168 - 174
Database
ISI
SICI code
8755-6863(200108)32:2<168:EOEPHO>2.0.ZU;2-6
Abstract
We investigated whether the combination of surfactant replacement therapy a nd early application of high-frequency oscillatory ventilation (HFOV) was m ore effective in patients with respiratory distress syndrome (RDS) than lat e application of HFOV and conventional mechanical ventilation (CMV). To det ermine this, we retrospectively reviewed the cases of 126 neonates with RDS who received surfactant replacement therapy within 4 hr after birth. Patie nts were grouped into those who received HFOV immediately after birth (HFOV group), those who initially were ventilated by CMV and subsequently receiv ed HFOV (CMV/HFOV group), and those who did not receive HFOV (CMV group). C hanges in respiratory system compliance (Crs), arterial-alveolar oxygen gra dient (a/ApO(2)), and mean airway pressure (MAP) were compared. Infants who received HFOV were less mature than those who received CMV. The a/ApO(2) measured immediately after birth before surfactant replacement th erapy was significantly lower in the HFOV and CMV/HFOV group than in the CM V group. After 72 hr, the Crs in the HFOV group was higher than in any othe r group and was significantly higher than the CMV/HFOV group at 48 and 120 hr. These results suggest that initiating HFOV in combination with surfactant r eplacement therapy immediately after birth provides effective ventilatory s upport for infants with RDS. (C)) 2001 Wiley-Liss. Inc.