Lung Recruitment Using High-Frequency Oscillation Volume Guarantee in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Neonatology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Linda Gai Rui Chen ◽  
Po-Yin Cheung ◽  
Brenda Hiu Yan Law
Keyword(s):  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
High Frequency ◽  
Saturation Index ◽  
Lung Recruitment ◽  
High Frequency Oscillation ◽  
Frequency Oscillation ◽  
Sustained Improvement ◽  
Respiratory Parameters ◽  
Before And After

<b><i>Background:</i></b> Stepwise lung recruitment maneuvers (LRMs) may be used in ventilated preterm infants. However, its use in high-frequency oscillation with volume guarantee (HFO-VG) is not well studied. <b><i>Methods:</i></b> Preterm infants treated with HFO-VG who had LRMs were identified. Patient and respiratory parameters were recorded. <b><i>Results:</i></b> Ten infants, median GA 25<sup>+6</sup> (IQR 24<sup>+2</sup>–27<sup>+0</sup>) weeks, and 21 LRMs were identified. LRMs were performed at a median age of 26 days, with a starting MAP of 16 (14–17) cm H<sub>2</sub>O and the highest MAP of 23.5 (22.0–24.8) cm H<sub>2</sub>O. Most (76%) resulted in immediate improved SpO<sub>2</sub>/FiO<sub>2.</sub> There were no sustained differences in median oxygen saturation index (8.4 vs. 9, <i>p</i> = 0.09), SpO<sub>2</sub>/FiO<sub>2</sub> (1.8 vs. 1.8, <i>p</i> = 0.8), ∆P (21 vs. 23, <i>p</i> = 0.64), or transcutaneous CO<sub>2</sub> (58 vs. 60, <i>p</i> = 0.84) in 24 h before and after LRMs. <b><i>Conclusions:</i></b> In preterm infants with evolving bronchopulmonary dysplasia, LRMs on HFO-VG did not result in sustained improvement to oxygenation or ventilation.

Rescue high frequency oscillation and predictors of adverse neurodevelopmental outcome in preterm infants

2002 ◽  
Vol 66 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Gabriel Dimitriou ◽  
Anne Greenough ◽  
Dylan Broomfield ◽  
Claire Barnett ◽  
Margaret Morton
Keyword(s):  
Preterm Infants ◽  
High Frequency ◽  
Neurodevelopmental Outcome ◽  
High Frequency Oscillation ◽  
Frequency Oscillation

scholarly journals Preliminary Effectiveness and Safety of High Frequency Oscillation in Addition to Mechanical Insufflation and Exsufflation for Intratracheal Mucus Removal in Patients With Neuromuscular Disease: Protocol for a Prospective Study (Preprint)

2018 ◽  
Author(s):  
Hiroyuki Awano ◽  
Masashi Nagai ◽  
Ryosuke Bo ◽  
Mariko Murao ◽  
Yusuke Ishida ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Prospective Study ◽  
Respiratory Tract Infection ◽  
High Frequency ◽  
High Frequency Oscillation ◽  
Frequency Oscillation ◽  
Transcutaneous Oxygen ◽  
Before And After ◽  
Tract Infections

BACKGROUND Mechanical insufflation-exsufflation (MI-E) is necessary for noninvasive management of respiratory clearance in patients with neuromuscular disorders (NMDs). Its utility has been proven, and the technique is recommended in a number of international guidelines for the management of patients with NMDs. However, the clearance of thick secretions adhering to the tracheobronchial walls could be problematic when these patients suffer from respiratory tract infections. To improve the effectiveness of the noninvasive technique, a novel device combining MI-E with high frequency oscillation (HFO) has been developed. However, the efficacy of HFO therapy in NMDs has not been well studied. OBJECTIVE The aim of this study was to elucidate the effect of MI-E combined with HFO for mucus removal in NMD patients. To evaluate its efficacy, changes in transcutaneous oxygen saturation (SpO2), which may predict intratracheal mucus removal, will be measured before and after use of MI-E. METHODS This is a single-center, nonblinded, nonrandomized prospective study that will enroll 5 subjects hospitalized in Kobe University Hospital owing to respiratory tract infection. All subjects will receive MI-E therapy a few times daily and will receive HFO every other day, for 6 days. Before and after MI-E use, SpO2 will be obtained and the change in SpO2 (ΔSpO2) between MI-E with and without HFO will be calculated. For every subject, the average of ΔSpO2 with or without HFO will be obtained and the null hypothesis that there is a mean change of 0 in the SpO2 between MI-E with and without HFO will be tested using the paired t test. If the treatment with HFO is found to be statistically significantly superior to the treatment without HFO, the study will conclude that HFO addition is more efficacious than no HFO addition. RESULTS A total of 2 subjects have already been recruited and enrolled in this study as of August 2018. CONCLUSIONS This unique protocol will assess the efficacy of adding HFO to MI-E during the acute phase of respiratory tract infection in patients with NMDs. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12102

Ventilatory response to high-frequency airway oscillation in humans

1985 ◽  
Vol 58 (4) ◽  
pp. 1099-1106 ◽  
Author(s):  
E. L. DeWeese ◽  
T. Y. Sullivan ◽  
P. L. Yu
Keyword(s):  
High Frequency ◽  
Ventilatory Response ◽  
Respiratory Control ◽  
High Frequency Oscillation ◽  
Frequency Oscillation ◽  
Pressure Oscillations ◽  
Respiratory Inductive Plethysmography ◽  
Before And After ◽  
Inspiratory Activity ◽  
Inductive Plethysmography

To investigate respiratory control during high-frequency oscillation (HFO), ventilation was monitored in conscious humans by respiratory inductive plethysmography during application at the mouth of high-frequency pressure oscillations. Studies were conducted before and after airway and pharyngeal anesthesia. During HFO, breathing became slow and deep with an increase in tidal volume (VT) of 37% (P less than 0.01) and inspiratory duration (TI) of 34% (P less than 0.01). Timing ratio (TI/TT) increased 14% (P less than 0.05) and respiratory frequency (f) decreased 12% (P less than 0.01). Mean inspiratory flow (VT/TI) did not change during HFO. Following airway anesthesia, VT increased only 26% during HFO (P less than 0.01), whereas significant changes in TI, TI/TT, and f were not observed. Pharyngeal anesthesia failed to diminish the effect of HFO on TI, TT, or f, although the increase in VT was reduced. These results indicate that 1) HFO presented in this manner alters inspiratory timing without affecting the level of inspiratory activity, and 2) receptors in the larynx and/or lower airways may in part mediate the response.

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