Early vs late high-frequency oscillatory ventilation in paediatric acute respiratory distress syndrome - A tertiary care centre experience

Abstract

RationaleOutcome data regarding the use of high-frequency oscillatory ventilation for the treatment of paediatric acute respiratory distress syndrome from low- and middle-income countries is limited. ObjectivesTo compare the outcomes of children with paediatric acute respiratory distress syndrome managed with early initiation of high-frequency oscillatory ventilation with those initiated after 48 h of intubation (late). MethodsRetrospective single centre observational study. Measurements and main resultsAmong the 17 subjects with paediatric acute respiratory distress syndrome (PaO2/FiO2 ratio <200, Oxygenation index >8) with significant hypoxia on highfrequency oscillatory ventilation, 11 patients (65%) fell into the early group and 6 (35%) to the late group. The early group had significantly lower lactates at 12 (p= 0.02), 24(p= 0.03) and 36 h(p= 0.04) of initiation as compared to the late group. The mortality was 65 % and 100 % in the early and late groups respectively (p = 0.1). ConclusionsEarly high-frequency oscillatory ventilation was associated with significantly lower lactate levels at different time points of initiation. It was not associated with any survival benefit.