scholarly journals Nasal High-Frequency Oscillatory Ventilation vs. Nasal Continuous Positive Airway Pressure as Therapy for Postextubation Respiratory Failure in Infants After Congenital Heart Surgery

2021 ◽  
Vol 9 ◽  
Author(s):  
Hong-Lin Wu ◽  
Yu-Qing Lei ◽  
Wen-Peng Xie ◽  
Qiang Chen ◽  
Yi-Rong Zheng
Keyword(s):  
High Frequency ◽  
Airway Pressure ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Positive Airway Pressure ◽  
Oxygenation Index ◽  
Congenital Heart Surgery ◽  
High Frequency Oscillatory Ventilation ◽  
Nasal Trauma ◽  
High Frequency Oscillatory

Objective: This study aimed to evaluate the effects of nasal high-frequency oscillatory ventilation (NHFOV) vs. nasal continuous positive airway pressure (NCPAP) on postextubation respiratory failure (PRF) in infants after congenital heart surgery (CHS).Method: Eighty infants underwent postoperative invasive mechanical ventilation for more than 12 h and planned extubation. The infants were randomized to undergo either NHFOV or NCPAP after extubation. Primary outcomes were the incidence of PRF and reintubation, the average PaCO2 level, the average oxygenation index (OI), and pulmonary recruitment in the early extubation phase. Secondary outcomes included the NCPAP/NHFOV time, length of hospital stay, treatment intolerance, signs of discomfort, pneumothorax, adverse hemodynamic effects, nasal trauma, and mortality.Results: Except for PaCO2 within 12 after extubation (39.3 ± 5.8 vs. 43.6 ± 7.3 mmHg, p = 0.05), there was no statistically significant difference for any of the primary outcome measure (PRF, reintubation within 12 h after extubation, oxygenation index within 12 h after extubation, or lung volumes on X-ray after extubation) or secondary outcome measures (duration of non-invasive ventilation, duration of hospital stay, ventilation intolerance, signs of discomfort, pneumothorax, nasal trauma, adverse hemodynamic effects, or death prior to discharge), p > 0.1 for each comparison.Conclusion: NHFOV therapy after extubation in infants after CHS was more efficient in improving CO2 cleaning than NCPAP therapy, but there was no difference in other outcomes (PRF, reintubation, oxygenation index, and pulmonary recruitment).

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).

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.

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