High-Frequency Ventilation and Extracorporeal Membrane Oxygenation

1990 ◽  
Vol 1 (2) ◽  
pp. 427-444 ◽  
Author(s):  
Charmaine White ◽  
Cliff Richardson ◽  
Libertad Raibstein
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
High Frequency ◽  
Assisted Ventilation ◽  
Pulmonary Complications ◽  
High Frequency Ventilation ◽  
Dramatic Improvement ◽  
Membrane Oxygenation ◽  
Frequency Ventilation ◽  
Short And Long Term

Dramatic improvement in morbidity and mortality associated with neonatal respiratory failure has evolved over the last 30 years. Favorable survival statistics can be directly related to the institution and refinement of assisted ventilation techniques. Short-and long-term pulmonary complications continue to be of major concern. New ways to support the neonate in respiratory failure are being investigated. Concentrated efforts are being undertaken to find ways to safely and effectively treat these infants while decreasing the morbidity associated with therapy. Two such therapies, both experimental and controversial, which are gaining widespread recognition, are high-frequency ventilation (HFV) and extracorporeal membrane oxygenation (ECMO)

High Frequency Ventilation for Immature Infants

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 280-287
Keyword(s):  
High Frequency ◽  
Ductus Arteriosus ◽  
Ventilatory Support ◽  
Oxygen Toxicity ◽  
Pulmonary Complications ◽  
High Frequency Ventilation ◽  
Controlled Clinical Trial ◽  
Dramatic Improvement ◽  
Widespread Application ◽  
Frequency Ventilation

There is increasing concern that the dramatic improvement in the survival of immature infants has been accompanied by an increase in incidence of pulmonary complications, some seriously crippling and eventually fatal.1 Both barotrauma and oxygen toxicity have been considered in the pathogenesis of these disorders; circulatory disorders as a result of failure of closure of the ductus arteriosus or fluid overload have also been proposed as contributory factors. Reports of successful application of the principles of high frequency ventilation (HFV) in the treatment of infants with respiratory distress syndrome (RDS)2-4 and particularly those with severe interstitial emphysema5 have raised hopes that this technique might prevent barotrauma to the lungs and have stimulated physicians and engineers to develop new equipment that might be useful in ventilating small infants. HFV, however has not been evaluated in infants with regard to efficacy or safety; and gas exchange is not well understood under those circumstances. Because of the rapidly growing interest in this type of ventilatory support, a workshop was convened to examine the state-of-the-art of this technique in the developing respiratory system and to identify areas requiring further investigation. It was also considered important to discuss the necessity and feasibility of conducting a controlled clinical trial of this new modality of care, prior to its widespread application. THEORETICAL CONSIDERATIONS HFV involves the use of small tidal volumes, delivered at respiratory frequencies ranging from 60 to 2,400 breaths per minute (1 to 40 Hz).6-11 There are several systems for delivering HFV, each of which has different characteristics and therefore may have different effects.

Inter-Hospital Transport of Neonatal Patients on Extracorporeal Membrane Oxygenation: Mobile-ECMO

PEDIATRICS ◽  
1995 ◽  
Vol 95 (4) ◽  
pp. 562-566
Author(s):  
Mark J. Heulitt ◽  
Bonnie J. Taylor ◽  
Sherry C. Faulkner ◽  
Lorrie L. Baker ◽  
Carl W. Chipman ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
High Frequency Ventilation ◽  
Medical Patients ◽  
Retrospective Case ◽  
Membrane Oxygenation ◽  
Limited Series ◽  
Frequency Ventilation ◽  
Hospital Transport

Objective. To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. Design. This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. Settings. The study was conducted at a regional referral children's hospital and ECMO unit. Patients. Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. Results. Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile- ECMO. Eight of these had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum. Conclusion. Our limited series shows that patients can be safely transported with mobile-ECMO. This program does not replace the early appropriate transfer for ECMO-eligible patients to an ECMO center.

External high-frequency ventilation in patients with respiratory failure (external ventilation)

1995 ◽  
Vol 21 (2) ◽  
pp. 191-191 ◽  
Author(s):  
L. Gaitini ◽  
S. Vaida ◽  
S. Krimerman ◽  
A. Werczberger ◽  
J. Smorgik ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Frequency ◽  
High Frequency Ventilation ◽  
Frequency Ventilation

scholarly journals Outcome of neonates receiving high frequency oscillation ventilation in a tertiary care institution

2019 ◽  
Vol 6 (3) ◽  
pp. 959
Author(s):  
Kalpana M. S. ◽  
Kalyani S.
Keyword(s):  
Respiratory Failure ◽  
High Frequency ◽  
Tertiary Care ◽  
Pulmonary Hemorrhage ◽  
Oxygenation Index ◽  
Lung Recruitment ◽  
High Frequency Oscillation ◽  
High Frequency Ventilation ◽  
Female Ratio ◽  
Frequency Ventilation

Background: High-frequency ventilation is defined as ventilation at a frequency greater than four times normal respiratory rate. HFOV has been used as alternative to conventional ventilation and in respiratory failure of various etiologies. The aim of the study was to identify the indications of neonates receiving HFOV, following failure of conventional ventilation.Methods: Total 93 neonates were enrolled in the study who received HFOV. The criteria for starting HFOV, the ventilator settings, CBG and ABG analysis, oxygenation index (OI), duration of ventilation and complications of ventilation were recorded during CMV and subsequently when shifted over to HFOV. Outcomes such as oxygenation, lung recruitment and ventilation and survival were monitored.Results: Total 66 neonates (71%) were term babies. Among the 27 preterm 18 (18.4%) were 33-34±6 weeks of gestational age. Male were 50 in number (53.8%) and female were 43 (46.2%). The male: female ratio was 50:43. Disease specific survival analysis revealed more than 50% survival in cases of pneumonia, collapse, air leak, MAS and pulmonary hemorrhage. 16 out of 33 babies (48.5%) with PPHN survived. All 3 babies with CDH expired. Of the 93 neonates included in the study, 53 (57%) of them were discharged home. The major complications noted while on HFOV were- 38 neonates (40.8%) had air leaks. Instead of, ventilator associated pneumonia was present in 42 of them (45.1%) and none of them developed IVH or NTB (Necrotising tracheo bronchitis).Conclusions: HFOV is a safe and effective technique in the treatment of neonates with respiratory failure in whom CMV fails. The results of present study show that rescue HFOV improved oxygenation, ventilation and lung recruitment and there was no increased incidence of IVH.

Sign in / Sign up

Export Citation Format

Share Document