title: High frequency oscillation for preterm infants with severe respiratory failure.
abstract: High frequency oscillation (HFO) as rescue treatment for preterm infants with severe respiratory failure has been assessed and prognostic factors identified. Thirty six infants with a median gestational age of 27 weeks were studied. Immediately before transfer to HFO, the infants were receiving an inspired oxygen concentration of > or = 85% and/or a mean airway pressure of > or = 12 cm H2O and had a median alveolar-arterial oxygen gradient (A-aDO2) of 73.28 kPa (range 49.34-89.91). Seventeen infants subsequently died. Comparison of those 17 with the remaining 19 infants demonstrated that respiratory distress syndrome and persistent fetal circulation were associated with a significantly better outcome than pulmonary airleak. The A-aDO2 after two and six hours on HFO was significantly higher in those infants who survived compared with those who died. We conclude that a diagnosis of pulmonary airleak and failure to show early improvement in respiratory status indicate a poor prognosis when HFO is used as rescue treatment.
authors.affiliation: Department of Child Health, King's College Hospital, London.
authors.forename: V
authors.initials: V
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Greenough
authors.forename: H R
authors.initials: HR
authors.lastname: Gamsu
mesh_terms: D000399:Air Pressure; D006612:High-Frequency Ventilation; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000628:therapy*; D010100:Oxygen / Q000502:physiology; D010547:Persistent Fetal Circulation Syndrome / Q000150:complications; D011030:Pneumothorax / Q000150:complications; D011379:Prognosis; D011656:Pulmonary Emphysema / Q000150:complications; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000401:mortality / Q000628:therapy*
chemical_list: D010100:Oxygen