title: High frequency oscillatory ventilation in children: experience of a medical center in Taiwan.
abstract: OBJECTIVE
  Data about the effectiveness of high frequency oscillatory ventilation (HFOV) in children with respiratory failure are limited. This study investigated the efficacy and prognostic factors of this treatment.
  
  
  METHODS
  Children between 2 months and 18 years of age who received HFOV between January 2000 and September 2006 in a tertiary care center were enrolled in this retrospective study.
  
  
  RESULTS
  Thirty-six HFOV treatments were given to 33 patients (twice in one patient and three times in another patient) at a mean age of 5.4 +/- 5.0 years. HFOV was used as a rescue after conventional mechanical ventilation (CMV) for 4.4 +/- 4.2 days. The mean duration of HFOV was 7.6 +/- 7.9 days. The most common indication for HFOV was oxygenation failure, which was due to pneumonia with acute respiratory distress syndrome in 15 (45.5%), severe lobar pneumonia in nine (27.3%), pulmonary hemorrhage in eight (24.2%) and pneumothorax in one (3%). PaCO2 was significantly improved 4 hours after HFOV and the PaO2/FiO2 ratio increased significantly 12 hours later. The oxygenation index and alveolar-arterial oxygen difference P(A-a)O2, however, did not change markedly. Four (12%) patients needed further extracorporeal life support and two of these survived. The overall survival rate was 45.5%. Patients with heavier body weight (p less than 0.05) and of the male gender (p less than 0.05) had a higher risk of mortality.
  
  
  CONCLUSIONS
  As a relatively late rescue therapy after failure of CMV, HFOV may improve PaCO2 and PaO2/FiO2 in children with respiratory failure. However, it carries an increased mortality rate in patients with heavier body weight and male gender.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Ching-Chia
authors.initials: CC
authors.lastname: Wang
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Wu
authors.forename: En-Ting
authors.initials: ET
authors.lastname: Wu
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
authors.forename: Frank Leigh
authors.initials: FL
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007223:Infant; D008297:Male; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D002245:Carbon Dioxide