Effect of High Frequency Ventilation on Tension Pneumothorax Induced by Conventional Ventilator

ABSTRACT

Four cases of newborn with tension pneumothorax induced by a conventional ventilator were admitted to our nursery from January 1. 1992 to June 30. 1992 and they were managed by high frequency ventilator (Infrasonic Infant Star Ventilator). In contrast, four cases of newborn with tension pneumothorax who were continuously on the conventional ventilator, were included as a control group. They were admitted to our nursery from July 1. 1991 to december 31. 1991 and they were managed by conventional ventilator with conservative treatment. 1) In the control group, who were continuously managed by the conventional ventilator after thoracostomy with water seal drainage, we changed ventilator setting appropriately in control group but they had poor arterial blood gas analysis. The arterial blood gas analysis within 24hr/within 72hr in control group were pH 7.192/7.195, Paco2 72.15/82.25, PaO2 78.92/83.875, HCO3-26.975/27.925 and conventional ventilator care did not show any definite benefit for improvement of arterial blood gas analysis and tension pneumothorax as well. 2) Two cases in control group expired on the 6th day of thoracostomy without any resolution of tension pneumothorax. 3) In contrast, four cases with tension pneumothorax managed by high frequency ventilator were improved. Tension pneumothorax and arterial blood gas analysis to normalize from 6hr of high frequency ventilation and four cases of tension pneumothorax were completely reabsorbed within 4days.