Rescue high frequency ventilation for congenital diaphragmatic hernia.
J Neonatal Perinatal Med
; 12(2): 173-178, 2019.
Article
in En
| MEDLINE
| ID: mdl-30829621
ABSTRACT
INTRODUCTION:
High frequency jet (HFJV) and oscillatory (HFOV) ventilation were used to rescue newborns with congenital diaphragmatic hernia (CDH), who failed conventional mechanical ventilation (CV). Changes in ventilator settings and pulmonary gas exchange were evaluated following transition to high frequency ventilation (HFV).METHODS:
Records of patients with CDH rescued with HFV prior to surgical intervention between 2006 and 2015 were reviewed. Mean airway pressure (Paw) and arterial blood gases during CV and those obtained within the first hour of HFV were compared. A composite repeated measure analysis was performed to evaluate longitudinal and intergroup variances.RESULTS:
Twenty-seven patients were rescued from CV, 16 by HFJV and 11 by HFOV. The two groups had similar gestational ages and birth weights. Prior to HFV, both groups had similar Paw, PaCO2, FiO2 and PaO2. HFV was associated with a significant improvement in ventilation, and the rate of decrease of PaCO2 was no different between groups. There was a significantly higher increase in Paw increase with HFOV compared to HFJV.CONCLUSIONS:
In newborns with CDH rescued with HFV, ventilation improved but Paw was significantly lower in patients supported with HFJV compared to HFOV.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiratory Insufficiency
/
High-Frequency Ventilation
/
Hernias, Diaphragmatic, Congenital
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Newborn
Language:
En
Journal:
J Neonatal Perinatal Med
Year:
2019
Document type:
Article
Affiliation country:
Estados Unidos