Nasal high-frequency ventilation for premature infants.
OBJECTIVE
To assess the use of nasal high-frequency ventilation (HFV) to provide noninvasive ventilatory support for very low birthweight (VLBW) infants.


METHODS
VLBW infants, >7 days of age on nasal continuous positive airway pressure (CPAP), were placed on nasal HFV for 2 h using the Infant Star high-frequency ventilator (Mallinckrodt, Inc., St. Louis, MO, USA). Mean airway pressure was set to equal the previous level of CPAP, and amplitude was adjusted to obtain chest wall vibration. Capillary blood was sampled before starting HFV and after 2 h to determine change in pH and partial pressure of carbon dioxide (pCO(2)).


RESULTS
Fourteen subjects were studied, 10 males and 4 females. Gestational age was 26-30 weeks (median 27). Age at study was 18-147 days (median 30). Median birth weight was 955 g; median weight at study was 1605 g. Nasal CPAP pressure was 4-7 cm H(2)O (mean 5). Amplitude was 30-60 (median 50). After 2 h, PCO(2) (mean 45 torr) was significantly lower than initial PCO(2) (mean 50 torr) (p = 0.01), and pH had increased significantly (7.40 vs. 7.37, p = 0.04).


CONCLUSIONS
Nasal HFV is effective in decreasing pCO(2) in stable premature infants requiring nasal CPAP support. Long-term use of nasal HFV requires further study.
Colaizy
Tarah T
TT
Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA. tarah-colaizy@uiowa.edu
Younis
Usama M M
UM
Bell
Edward F
EF
Klein
Jonathan M
JM
D002245:Carbon Dioxide / Q000097:blood*; D045422:Continuous Positive Airway Pressure; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*
D002245:Carbon Dioxide