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High-frequency oscillatory ventilation with low oscillatory frequency in pulmonary interstitial emphysema

Citation

Squires, KAG and De Paoli, AG and Williams, C and Dargaville, PA, High-frequency oscillatory ventilation with low oscillatory frequency in pulmonary interstitial emphysema, Neonatology: fetal and neonatal research, 104, (4) pp. 243-249. ISSN 1661-7800 (2013) [Refereed Article]

Copyright Statement

Copyright 2013 S. Karger AG

DOI: doi:10.1159/000353376

Abstract

Background: Pulmonary interstitial emphysema (PIE) is a common respiratory illness in preterm infants associated with significant morbidity and mortality for which the ventilatory management is imperfect.

Objectives: To evaluate the impact of high-frequency oscillatory ventilation (HFOV) with a low oscillatory frequency and thus prolonged expiratory time in preterm infants with severe PIE.

Methods: In a retrospective cohort study, preterm infants ≤30 weeks' gestation with radiological findings of severe PIE, and either high FiO2 or persistent respiratory acidosis were studied if managed on HFOV with a low frequency (5-6 Hz, inspiratory time 30%) for >24 h. Trends in physiological and ventilatory parameters were examined over the first 72 h, radiological changes noted, and in-hospital outcomes ascertained.

Results: 19 cases were identified and analysed in two groups: 14 with bilateral and 5 with predominantly unilateral disease. After transition to low-frequency HFOV, physiological responses were seen in both groups, in particular a rapid and sustained improvement in oxygenation in the bilateral group (mean (SD) alveolar-arterial oxygen difference at baseline: 404 206 mm Hg; 4 h post-transition: 262 181 mm Hg; 72 h: 155 74 mm Hg; p = 0.0003). This occurred following a reduction in mean airway pressure (mean (SD) baseline: 14 3.9 cm H2O; 72 h: 12 2.9 cm H2O; p = 0.011). In the unilateral group, radiological resolution of PIE was observed on re-inflation following collapse of the affected lung. Overall, 15 infants survived, including 10 of the bilateral cases (71%), and all of the unilateral cases.

Conclusion: HFOV with a low oscillatory frequency may afford benefit in preterm babies with severe PIE.

Item Details

Item Type:Refereed Article
Keywords:High-frequency oscillatory ventilation, Infant, preterm, Pulmonary interstitial emphysema
Research Division:Medical and Health Sciences
Research Group:Paediatrics and Reproductive Medicine
Research Field:Paediatrics
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Squires, KAG (Dr Katharine Squires)
Author:De Paoli, AG (Dr Tony De Paoli)
Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:87928
Year Published:2013
Web of Science® Times Cited:8
Deposited By:Menzies Institute for Medical Research
Deposited On:2013-12-17
Last Modified:2017-11-06
Downloads:5 View Download Statistics

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