Effect of High-Frequency Oscillatory Ventilation Combined With Pulmonary Surfactant in the Treatment of Acute Respiratory Distress Syndrome After Cardiac Surgery: A Prospective Randomised Controlled Trial.

Yi-Rong Zheng,Hong-Lin Wu,Shu-Ting Huang,Yu-Qing Lei,Hua Cao,Ning Xu,Jian-Feng Liu,Qiang Chen

doi:10.3389/fcvm.2021.675213

Abstract

Background: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery.Methods: A total of 61 infants with ARDS were eligible and were randomised to the CMV + PS group (n = 30) or the HFOV + PS group (n = 31) between January 2020 and December 2020. The primary outcomes were the changes in arterial blood gas parameters. The duration of mechanical ventilation, length of hospitalisation and the incidence of complications were considered secondary outcomes.Results: A total of 61 infants completed the study. In the HFOV + PS group, the blood gas analysis results were significantly improved (P < 0.05), while the duration of mechanical ventilation and length of hospitalisation were shorter than the CMV + PS group (P < 0.05). However, the incidence of complications was not different between the two groups (P > 0.05).Conclusions: Compared with the CMV + PS group, the HFOV + PS group showed significantly improved ABG variables and had a shortened length of hospitalisation and mechanical ventilation in infants with ARDS after cardiac surgery.Clinical Trial Registration: Chinese Clinical Trial Registry; Number: ChiCTR2000039457.

Highlights

The continuous improvement of cardiopulmonary bypass technology has increased the safety of surgical correction of congenital heart disease (CHD)
This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery
In the HFOV + PS group, the blood gas analysis results were significantly improved (P < 0.05), while the duration of mechanical ventilation and length of hospitalisation were shorter than the CMV + PS group (P < 0.05)

Summary

Introduction

The continuous improvement of cardiopulmonary bypass technology has increased the safety of surgical correction of congenital heart disease (CHD). Acute lung injury and acute respiratory distress syndrome (ARDS) often occur after cardiopulmonary bypass (CPB). HFOV + PS inhalation therapy has demonstrated good effects in the treatment of various respiratory diseases in newborns and infants, such as NRDS, congenital diaphragmatic hernia and meconium aspiration syndrome [9, 10]. The purpose of this study is to evaluate the efficacy and safety of HFOV + PS vs conventional mechanical ventilation (CMV) + PS in the treatment of ARDS after cardiac surgery. This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery

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Methods

Results

Discussion

Conclusion