Noninvasive High-Frequency Oscillatory Ventilation: A Retrospective Chart Review

2020 ◽  
Author(s):  
Yaser A.H. Ali ◽  
Mary M. Seshia ◽  
Ebtihal Ali ◽  
Ruben Alvaro
Keyword(s):  
High Frequency ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Retrospective Chart Review ◽  
High Frequency Oscillatory Ventilation ◽  
Oscillatory Ventilation ◽  
Key Points ◽  
Before And After ◽  
Oxygen Requirements ◽  
High Frequency Oscillatory

Objective This study aimed to review the feasibility of nasal high-frequency oscillatory ventilation (NHFOV) in preventing reintubation in preterm infants Study Design This is a retrospective cohort study of all premature newborn infants placed on NHFOV in a single-center neonatal intensive care unit. Results Twenty-seven patients (birth weight: 765 ± 186 g, gestational age: 28 ± 2 weeks) were commenced on NHFOV on 32 occasions. NHFOV was used immediately postextubation as the primary mode of noninvasive ventilation (NIV; prophylaxis) in 10 of 32 occasions and as “rescue” (failure of NCPAP or biphasic CPAP) in 22 of 32 occasions. Treatment with NHFOV was successful in 22 occasions (69%) while on 10 occasions (31%) reintubation was required within 72 hours. In the rescue group, there was significant reduction in the mean (standard deviation [SD]) number of apneas (0.9 ± 1.07 vs. 0.3 ± 0.29, p < 0.005), but there were no significant changes in the PCO2 level (52 [ ±  9.8] vs. 52 [ ±  8.6] mm Hg, p = 0.8), or the FiO2 requirement (0.39 ± 0.19 vs. 0.33 ± 0.10, p = 0.055) before and after commencing NHFOV, respectively. Conclusion The use of NHFOV is feasible as a prophylactic or rescue mode of NIV following extubation and was associated with decrease in the number of apneas without significant changes in PCO2 or oxygen requirements. A well-designed randomized control trial is needed to determine the indications, clinical outcomes, and safety of this treatment modality. Key Points

scholarly journals High-Frequency Oscillatory Ventilation Combined with Volume Guarantee in a Neonatal Animal Model of Respiratory Distress Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Manuel Sánchez Luna ◽  
Martín Santos González ◽  
Francisco Tendillo Cortijo
Keyword(s):  
Animal Model ◽  
High Frequency ◽  
Distress Syndrome ◽  
Lung Surfactant ◽  
High Frequency Oscillatory Ventilation ◽  
Constant Frequency ◽  
Oscillatory Ventilation ◽  
Before And After ◽  
Lung Condition ◽  
High Frequency Oscillatory

Objective. To assess volume guarantee (VG) ventilation combined with high-frequency oscillatory ventilation (HFOV) strategy on PaCO2regulation in an experimental model of neonatal distress syndrome.Methods. Six 2-day-old piglets weighing  kg were used for this interventional experimental study. Animals were ventilated during physiologic lung conditions and after depletion of lung surfactant by bronchoalveolar lavage (BAL). The effect of HFOV combined with VG on PaCO2was evaluated at different high-frequency expired tidal volume (VThf) at constant frequency () and mean airway pressure (mPaw). Fluctuations of the pressure (ΔPhf) around the mPaw and PaCO2were analyzed before and after lung surfactant depletion.Results. PaCO2levels were inversely proportional to VThf. In the physiological lung condition, an increase in VThf caused a significant decrease in PaCO2and an increase in ΔPhf. After BAL, PaCO2did not change as compared with pre-BAL situation as the VThf remained constant by the ventilator.Conclusions. In this animal model, using HFOV combined with VG, changes in the VThf settings induced significant modifications in PaCO2. After changing the lung condition by depletion of surfactant, PaCO2remained unchanged, as the VThf setting was maintained constant by modifications in the ΔPhf done by the ventilator.

New Ventilator Strategies: High-Frequency Oscillatory Ventilation Combined with Volume Guarantee

2018 ◽  
Vol 35 (06) ◽  
pp. 545-548 ◽  
Author(s):  
N. González-Pacheco ◽  
J. Belik ◽  
M. Santos ◽  
F. Tendillo ◽  
M. Sánchez-Luna
Keyword(s):  
Tidal Volume ◽  
High Frequency ◽  
Animal Studies ◽  
Newborn Infants ◽  
High Frequency Oscillatory Ventilation ◽  
Very High Frequency ◽  
Oscillatory Ventilation ◽  
New Strategy ◽  
Lung Trauma ◽  
High Frequency Oscillatory

AbstractHigh-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV–volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Different I:E ratios also can modify the effect of CO2 washout during HFOV combined with VG in a different way as without the VG modality. Finally, clinical use of this technique in newborn infants has demonstrated the possibility of using very high frequency combined with constant very low VThf to decrease the risk of lung trauma related to the ventilator.

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