title: Nasal high-frequency oscillation ventilation in neonates: a survey in five European countries.
abstract: Nasal high-frequency oscillation ventilation (nHFOV) is a non-invasive ventilation mode that applies an oscillatory pressure waveform to the airways using a nasal interface. nHFOV has been shown to facilitate carbon dioxide expiration, but little is known about its use in neonates. In a questionnaire-based survey, we assessed nHFOV use in neonatal intensive care units (NICUs) in Austria, Switzerland, Germany, the Netherlands, and Sweden. Questions included indications for nHFOV, equipment used, ventilator settings, and observed side effects. Of the clinical directors of 186 NICUs contacted, 172 (92 %) participated. Among those responding, 30/172 (17 %) used nHFOV, most frequently in premature infants <1500 g (27/30) for the indication nasal continuous positive airway pressure (nCPAP) failure (27/30). Binasal prongs (22/30) were the most common interfaces. The median (range) mean airway pressure when starting nHFOV was 8 (6-12) cm H2O, and the maximum mean airway pressure was 10 (7-18) cm H2O. The nHFOV frequency was 10 (6-13) Hz. Abdominal distension (11/30), upper airway obstruction due to secretions (8/30), and highly viscous secretions (7/30) were the most common nHFOV side effects.
  
  
  CONCLUSIONS
  In a number of European NICUs, clinicians use nHFOV. The present survey identified differences in nHFOV equipment, indications, and settings. Controlled clinical trials are needed to investigate the efficacy and side effects of nHFOV in neonates.
authors.affiliation: Department of Neonatology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, hendrik.fischer@charite.de.
authors.forename: Hendrik Stefan
authors.initials: HS
authors.lastname: Fischer
authors.forename: Kajsa
authors.initials: K
authors.lastname: Bohlin
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Gerd
authors.initials: G
authors.lastname: Schmalisch
authors.forename: Malte
authors.initials: M
authors.lastname: Cremer
authors.forename: Irwin
authors.initials: I
authors.lastname: Reiss
authors.forename: Christoph
authors.initials: C
authors.lastname: Czernik
mesh_terms: D001317:Austria; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects / Q000379:methods*; D005858:Germany; D006612:High-Frequency Ventilation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D009426:Netherlands; D063087:Noninvasive Ventilation / Q000009:adverse effects / Q000379:methods*; D011795:Surveys and Questionnaires; D013548:Sweden; D013557:Switzerland