Clinical outcome of high frequency ventilation in neonates in neonatal intensive care unit

Abstract

Background: Pulmonary disease is a major cause of mortality and morbidity in neonates. Some of them may require mechanical ventilation with high mean airway pressures to maintain adequate gas exchange. More unconventional modalities such as inverse ratio ventilation, high frequency ventilation or extracorporeal membrane oxygenation (ECMO) may be needed. Objective: To study the clinical outcome of neonates managed with HFV for past 5 years in Neonatal Intensive Care Unit (NICU). Methods: A retrospective study conducted at NICU from January 2007 to June 2013. All neonates who were managed with HFV were included in the study. Result: There were 39 neonates who were ventilated with HFV during that period. The survival rate was 20.5% (8 out of 39 subjects). 18 developed pulmonary hypertension, 5 of whom survived. Six (15.4%) presented with primary pulmonary hypertension (PHN) and 12 (30.8%) developed secondary PHN. In the survived group, 12.5% developed chronic lung disease and periventricular leukomalacia and in the expired group, 25.8% developed pulmonary haemorrhage. Conclusions: When HFV is instituted in infants who fail to show improvement with conventional ventilation, statistically significant improvement in arterial oxygen tension may occur without any change in oxygenation index. A longer period of conventional ventilation prior to HFV could be one of the factors that could interfere with the successful management with HFV.