title: High-frequency oscillatory ventilation in children: a 10-year experience.
abstract: OBJECTIVE
  The aim of the study was to describe the experience with high-frequency oscillatory ventilation (HFOV) in a Portuguese Pediatric Critical Care Unit, and to evaluate whether HFOV allowed improvement in oxygenation and ventilation.
  
  
  METHODS
  This was a retrospective observational cohort study of children ventilated by HFOV between January, 2002 and December, 2011. The following parameters were recorded: demographic and clinical data, and blood gases and ventilatory parameters during the first 48 hours of HFOV.
  
  
  RESULTS
  80 children were included, with a median age of 1.5 months (min: one week; max: 36 months). Pneumonia (n=50; 62.5%) and bronchiolitis (n=18; 22.5%) were the main diagnoses. Approximately 40% (n=32) of the patients developed acute respiratory distress syndrome (ARDS). Conventional mechanical ventilation was used in 68 (85%) of patients prior to HFOV. All patients who started HFOV had hypoxemia, and 56 (70%) also presented persistent hypercapnia. Two hours after starting HFOV, a significant improvement in SatO2/FiO2 ratio (128±0.63 vs. 163±0.72; p<0.001) that was sustained up to 24 hours of HFOV and a decrease in FiO2 were observed. Since the beginning of HFOV, the mean PCO2 significantly decreased (87±33 vs. 66±25; p<0.001), and the pH significantly improved (7.21±0.17 vs. 7.32±0.15; p<0.001). Overall survival was 83.8%.
  
  
  CONCLUSIONS
  HFOV enabled an improvement in hypercapnia and oxygenation. It is a safe option for the treatment of ARDS and severe small airway diseases.
authors.affiliation: Pediatric Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal. marta.moniz@gmail.com
authors.forename: Marta
authors.initials: M
authors.lastname: Moniz
authors.forename: Catarina
authors.initials: C
authors.lastname: Silvestre
authors.forename: Pedro
authors.initials: P
authors.lastname: Nunes
authors.forename: Clara
authors.initials: C
authors.lastname: Abadesso
authors.forename: Ester
authors.initials: E
authors.lastname: Matias
authors.forename: Helena
authors.initials: H
authors.lastname: Loureiro
authors.forename: Helena
authors.initials: H
authors.lastname: Almeida
mesh_terms: D001784:Blood Gas Analysis; D001938:Brazil / Q000453:epidemiology; D001988:Bronchiolitis / Q000628:therapy; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006612:High-Frequency Ventilation / Q000009:adverse effects / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D011014:Pneumonia / Q000628:therapy; D012123:Pulmonary Ventilation; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome