High frequency oscillatory ventilation in infants with increased intra-abdominal pressure.
OBJECTIVE
To describe the short term effect of high frequency oscillatory ventilation on infants with severe abdominal distension who could not be conventionally ventilated.


METHODS
Eight infants (25 to 38 gestational weeks, birthweight 600-3200 g, postnatal age 1 to 190 days) with a variety of intra-abdominal pathologies, resulting in severe abdominal distension and failure of conventional ventilation, were studied.


RESULTS
The oxygenation status of all infants significantly improved within an hour of changing from conventional to high frequency oscillatory ventilation. Infants who were hypercapneic on conventional ventilation also showed a reduction in PaCO2. As a group, the mean (SD) PaO2/FIO2 improved from 4.99 (0.98) kpa to 11.55 (3.8) kpa (P = 0.002), and the PaCO2 from 6.48 (2.12) kpa to 4.89 (1.22) kpa (P = 0.028). These improvements were sustained throughout the next 48 hours.


CONCLUSIONS
High frequency oscillatory ventilation seems to be an effective rescue measure for infants with respiratory failure secondary to increased intra-abdominal pressure.
Fok
T F
TF
Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Ng
P C
PC
Wong
W
W
Lee
C H
CH
So
K W
KW
D000005:Abdomen; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011312:Pressure; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome