title: Effect of Volume Guarantee in Preterm Infants on High-Frequency Oscillatory Ventilation: A Pilot Study.
abstract: ObjectivesAlthough adding volume guarantee (VG) to conventional ventilation has been a well-established respiratory management for preterm infants, the evidence of VG combined with high-frequency oscillatory ventilation (HFOV) has not been studied well. The aim of this study was to investigate the effect of VG added to HFOV on respiratory and other physiological parameters.MethodsWe conducted a pilot study in extremely low-birth-weight infants ventilated with HFOV + VG with stable pulmonary status after 28 days of age. VG was applied for 6 hours and removed for the following 6 hours, and data were collected during these 12 hours.ResultsSix neonates were included in this study (gestational age: 22w5d-23w6d, birthweight: 424-584 g). High-frequency expired tidal volume per weight and amplitude were similar between periods with and without VG. Fluctuation of SpO2, but not heart rate, was significantly smaller when babies were ventilated with VG than without VG. Fluctuation of minute volume and carbon dioxide diffusion coefficient significantly increased after VG removal. The proportion of time with SpO2< 80% was decreased by VG overall, especially in three cases.ConclusionThis pilot study suggests VG combined with HFOV attenuates fluctuation of SpO2and CO2clearance, which may prevent hypoxemia and hypocapnia.
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Enomoto
authors.affiliation: Department of Pediatrics, Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, Rhode Island.
authors.forename: Martin
authors.initials: M
authors.lastname: Keszler
authors.affiliation: Clinical Research Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Sakuma
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Kikuchi
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Katayama
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Takei
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikegami
authors.affiliation: Department of Pediatrics and Neonatology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Minami
mesh_terms: D002245:Carbon Dioxide / Q000378:metabolism; D005260:Female; D005865:Gestational Age; D006339:Heart Rate; D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D016857:Hypocapnia / Q000209:etiology / Q000378:metabolism; D000860:Hypoxia / Q000209:etiology / Q000378:metabolism; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010092:Oximetry; D010865:Pilot Projects; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D013990:Tidal Volume
chemical_list: D002245:Carbon Dioxide