scholarly journals Nasal high-frequency oscillatory ventilation (nHFOV) versus nasal continuous positive airway pressure (NCPAP) as an initial therapy for respiratory distress syndrome (RDS) in preterm and near-term infants

2019 ◽  
Vol 3 (1) ◽  
pp. e000443 ◽  
Author(s):  
Ramin Iranpour ◽  
Amir-Mohammad Armanian ◽  
Ahmad-Reza Abedi ◽  
Ziba Farajzadegan
Keyword(s):  
High Frequency ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
High Frequency Oscillatory Ventilation ◽  
Respiratory Support ◽  
Term Infants ◽  
Non Invasive ◽  
Near Term ◽  
High Frequency Oscillatory

BackgroundCurrently, various forms of non-invasive respiratory support have been used in the management of respiratory distress syndrome (RDS) in preterm neonates. However, nasal high-frequency oscillatory ventilation (nHFOV) has not yet been applied commonly as an initial treatment.ObjectivesThis study was designed to investigate the efficacy and safety of nHFOV compared with nasal continuous positive airway pressure (NCPAP) in preterm and near-term infants with RDS.MethodsIn a randomised clinical trial, a total of 68 neonates (gestational age (GA) between 30 and 36 weeks and 6 days) with a clinical diagnosis of RDS were randomly assigned to either the NCPAP (n=34) or the nHFOV (n=34) group. The primary outcome was the duration of non-invasive respiratory support (duration of using NCPAP or nHFOV).ResultThe median (IQR) duration of non-invasive respiratory support, was significantly shorter in the nHFOV group than that in the NCPAP group (20 (15–25.3) versus 26.5 (15–37.4) hours, respectively; p=0.02). The need for a ventilator occurred in 4 out of 34 (11.8%) neonates in the NCPAP group and in none of the neonates in the nHFOV group (p=0.03). In addition, intraventricular haemorrhage (IVH) occurred in nine cases (6.9%) in the NCPAP group and two cases (3.3%) in the nHFOV group, which showed a significant difference (p=0.04). The incidence of pneumothorax, chronic lung disease, pulmonary haemorrhage and necrotising enterocolitis was similar between the two groups.ConclusionThis study showed that nHFOV significantly reduced the duration of non-invasive respiratory support and decreased the need for intubation compared with NCPAP in infants with RDS. Furthermore, nHFOV seems to reduce the incidence of IVH without increasing other complications.Trial registration numberIRCT2017062734782N1.

Frühgeborene: Nasale Hochfrequenz-Oszillationsbeatmung vs. nasaler CPAP

2021 ◽  
Vol 225 (05) ◽  
pp. 389-390
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
High Frequency ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
High Frequency Oscillatory Ventilation ◽  
Oscillatory Ventilation ◽  
High Frequency Oscillatory

Viele Frühgeborene mit einem Atemnotsyndrom (engl. Respiratory Distress Syndrome, RDS) erhalten zunächst eine nicht invasive Atemunterstützung. Ein chinesisches Forscherteam untersuchte nun, welche Methode besser vor einem invasiven mechanischen Beatmungsbedarf schützte: Der nasale CPAP (Continuous Positive Airway Pressure) oder die nasale HFOV (High-Frequency Oscillatory Ventilation).

Non-invasive high-frequency oscillatory ventilation in preterm infants: a randomised controlled cross-over trial

2017 ◽  
Vol 103 (4) ◽  
pp. F1-F5 ◽  
Author(s):  
Daniel Klotz ◽  
Hendryk Schneider ◽  
Stefan Schumann ◽  
Benjamin Mayer ◽  
Hans Fuchs
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
High Frequency ◽  
Airway Pressure ◽  
High Frequency Oscillatory Ventilation ◽  
Respiratory Support ◽  
Secondary Outcome ◽  
Non Invasive ◽  
Randomised Controlled ◽  
High Frequency Oscillatory

ObjectiveNon-invasive high-frequency oscillatory ventilation (nHFOV) has recently been described as a novel mode of respiratory support for premature infants. This study was designed to determine whether nHFOV decreases CO2 partial pressure (pCO2) in premature infants more effectively than non-invasive continuous positive airway pressure (nCPAP).DesignNon-blinded prospective randomised controlled cross-over study.SettingUniversity Medical Center tertiary neonatal intensive care unit.Patients26 premature infants of 27±2 weeks of gestational age after extubation or non-invasive surfactant treatment.InterventionsInfants were treated with 4 hours of nHFOV and 4 hours of nCPAP in a cross-over design. The sequence of the ventilation mode was randomly allocated.Main outcome measuresThe primary outcome measure was pCO2 of arterial or arterialised blood 4 hours after commencing the respective mode of respiratory support. Secondary outcome criteria included events of apnoea and bradycardia, respiratory rate, heart rate, pain and/or discomfort, mean airway pressure, fraction of inspired oxygen and failure of non-invasive respiratory support.ResultspCO2 after 4 hours of nHFOV was similar compared with 4 hours of nCPAP (p=0.33). pCO2 was 54.8 (14.6) vs 52.7 (9.3) mm Hg mean (SD) for the nHFOV–nCPAP period (n=13) and 49.0 (8.1) vs 47.7 (9.5) mm Hg for the nCPAP–nHFOV period (n=13). There was no difference in any of the secondary outcome measures. nHFOV was terminated prematurely in five cases for predefined failure criteria (p=0.051).ConclusionsWe could not demonstrate an increased carbon dioxide clearance applying nHFOV compared with nCPAP in this cohort of preterm infants.Trial registration numberDRKS00007171, results.

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