title: Nonpulmonary organ failure and outcome in children treated with high-frequency oscillatory ventilation.
abstract: OBJECTIVE
  The purpose of this study was to quantitate the contribution of nonpulmonary organ failure to mortality of patients treated with high-frequency oscillatory ventilation (HFOV) and to determine which gas-exchange differences are associated with improvement on HFOV.
  
  
  METHODS
  Charts of all patients treated with HFOV in our pediatric intensive care unit from January 1992 until January 1997 were retrospectively reviewed.
  
  
  RESULTS
  Sixty-six patients were treated and 21 patients improved during HFOV (group 1); 45 patients did not improve (group 2). Seventeen patients (26%) had isolated respiratory failure and their mortality was 12%. Percentages of patients with 2, and 3 or more organ failure were 45%, 29%, and their mortality was significantly higher, 67% and 95%, respectively. Patients with primary respiratory failure demonstrated a significantly greater risk of improvement on HFOV (RR ratio of 2.5, 95% CI 1.5 to 4.2). There was a significantly greater proportion of patients with primary cardiac failure who did not improve on HFOV compared with all other patients. Oxygenation index significantly improved over the first 72 hours for both groups, but then significantly worsened over the next 48 hours in group 2 but not in group 1.
  
  
  CONCLUSIONS
  Patients with nonpulmonary organ failure were significantly less likely to improve on HFOV and had a significantly higher mortality than patients with isolated respiratory failure. Children who do not improve on HFOV appear to reach a plateau in oxygenation indices after 3 days of HFOV.
authors.affiliation: Department of Pediatrics, Children's Hospital and Regional Medical Center and University of Washington School of Medicine, Seattle, USA.
authors.forename: T V
authors.initials: TV
authors.lastname: Brogan
authors.forename: S L
authors.initials: SL
authors.lastname: Bratton
authors.forename: R J
authors.initials: RJ
authors.lastname: Meyer
authors.forename: P P
authors.initials: PP
authors.lastname: O'Rourke
authors.forename: D S
authors.initials: DS
authors.lastname: Jardine
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D009102:Multiple Organ Failure; D011659:Pulmonary Gas Exchange; D012189:Retrospective Studies; D016896:Treatment Outcome