Effectiveness of high-frequency oscillatory ventilation for the treatment of neonatal meconium aspiration syndrome

Extracorporeal membrane oxygenation (ECMO), a technique for providing life support to patients with cardiac and/or respiratory dysfunction, allows the heart and lungs to “rest.” The neonatal respiratory population has been a major benefactor of ECMO since 1982. Its use for neonatal respiratory disease increased dramatically until the past few years, when the number of neonatal respiratory ECMO cases began a downward trend. Fewer patients with persistent pulmonary hypertension of the newborn (PPHN), meconium aspiration syndrome, respiratory distress syndrome, or sepsis are requiring ECMO support as frequently as in the past. Many attribute this decline to the newer respiratory therapies—mainly, surfactant, high-frequency oscillatory ventilation, and inhaled nitric oxide. Neonates who continue to require ECMO today are sicker than the historic norm and have more complicated and lengthy ECMO runs. Patients with congenital diaphragmatic hernia, PPHN, and sepsis remain the most consistent in their representation among ECMO recipients within this author’s institution, suggesting that the newer respiratory therapies have not had the same impact on these patients’ needs for ECMO support. Better guidelines for determining which patients would benefit from earlier inititation of ECMO are needed.

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High-frequency oscillatory ventilation versus conventional ventilation in a piglet model of early meconium aspiration

Critical Care Medicine ◽

10.1097/00003246-199803000-00031 ◽

1998 ◽

Vol 26 (3) ◽

pp. 556-561 ◽

Cited By ~ 18

Author(s):

Wayne E. Hachey ◽

Fabien G. Eyal ◽

Nicole L. Curtet-Eyal ◽

Franklin E. Kellum

Keyword(s):

High Frequency ◽

High Frequency Oscillatory Ventilation ◽

Conventional Ventilation ◽

Meconium Aspiration ◽

Oscillatory Ventilation ◽

High Frequency Oscillatory

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The clinical effects of high-frequency oscillatory ventilation in the treatment of neonatal severe meconium aspiration syndrome complicated with severe acute respiratory distress syndrome

BMC Pediatrics ◽

10.1186/s12887-021-03042-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guang Yang ◽

Yunxia Qiao ◽

Xinxin Sun ◽

Tiandan Yang ◽

Aiying Lv ◽

...

Keyword(s):

Mechanical Ventilation ◽

High Frequency ◽

Distress Syndrome ◽

Meconium Aspiration Syndrome ◽

High Frequency Oscillatory Ventilation ◽

Air Leakage ◽

Meconium Aspiration ◽

Oxygen Inhalation ◽

Mechanical Ventilation Time ◽

High Frequency Oscillatory

Abstract Objective To explore the efficacy and safety of high-frequency oscillatory ventilation (HFOV) in the treatment of severe meconium aspiration syndrome (MAS) complicated with severe acute respiratory distress syndrome (ARDS). Methods A total of 65 infants with severe MAS complicated with severe ARDS were included in the study. The clinical efficacy of treatment for the HFOV group (n = 31) and the conventional mechanical ventilation (CMV) group (n = 34) was retrospectively analysed. The partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), PaO2/fraction of inspired oxygen (FiO2), and oxygen index values before and at 6, 12, 24, 48, and 72 h after mechanical ventilation, the mechanical ventilation time, oxygen inhalation time, incidence of complications, and outcomes of the two groups were compared. Results At 6, 12, 24, and 48 h after mechanical ventilation, the PaO2 in the HFOV group was significantly higher than in the CMV group, while the PaCO2 in the HFOV group was significantly lower than in the CMV group (P < 0.05). At 6, 12, 24, 48, and 72 h after mechanical ventilation, PaO2/FiO2 in the HFOV group was significantly higher than in the CMV group, and the OI in the HFOV group was significantly lower than in the CMV group (P < 0.05). Mechanical ventilation time, oxygen inhalation time, and the incidence of air leakage were significantly lower in the HFOV than in the CMV group (P < 0.05). Conclusions Overall, HFOV can effectively improve lung ventilation and oxygenation function, shorten ventilator treatment time, and reduce the incidence rate of air leakage for neonatal MAS, making it a safe and effective treatment option.

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