[The efficacy of high frequency ventilation in severe neonatal respiratory failure].
OBJECTIVE
To evaluate the efficacy of high frequency ventilation (HFV) in infants failing conventional ventilator therapy at our institution.


METHODS
Medical records of all infants managed on HFV after having failed conventional ventilator management from 1994-2004 were reviewed. Ventilatory settings, blood gases and pH just prior to starting HFV, and two and four hours after starting HFV were recorded.


RESULTS
Sixty one infants met the study criteria. At two hours of HFV there was a significant improvement in oxygenation (Alveolar to arterial oxygen tension difference), ventilation and acid-base balance. These values were not significantly different between two and four hours of HFV. There was no significant difference in oxygenation between survivors (n=41) and non-survivors (n=20) prior to HFV, but after two hours of HFV the survivors had significant improvement in oxygenation. Thirty one of the survivors had improved oxygenation at two and four hours of HFV, but only eight of the nonsurvivors (p=0.03).


CONCLUSIONS
HFV results in significant improvements in oxygenation, ventilation and acid-base balance in most infants failing conventional ventilatory management. The immediate response to HFV may be a predictor of survival in infants with severe hypoxic respiratory failure.
Rúnarsdóttir
Sólrún Björk
SB
Háskóli Islands, laeknadeild, Landspítala Hringbraut, Reykjavík.
Dagbjartsson
Atli
A
Pálsson
Gestur
G
Bergsteinsson
Hörour
H
Kjartansson
Sveinn
S
Thornórkelsson
Thornórour
T
D000136:Acid-Base Equilibrium; D001158:Arteries / Q000378:metabolism; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D006863:Hydrogen-Ion Concentration; D000860:Hypoxia / Q000378:metabolism / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D010100:Oxygen / Q000097:blood / Q000378:metabolism*; D011175:Positive-Pressure Respiration; D011650:Pulmonary Alveoli / Q000378:metabolism; D012131:Respiratory Insufficiency / Q000097:blood / Q000378:metabolism* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D002245:Carbon Dioxide; D010100:Oxygen