Elective high-frequency oscillatory ventilation in preterm neonates: a preliminary investigation in a developing country

Abstract

Background: Elective high-frequency oscillatory ventilation (HFOV) in preterm infants is known to be as effective as conventional ventilation in the prevention of bronchopulmonary dysplasia without the risk of increased mortality or brain damage.Objective: To document the feasibility and safety of early use of HFOV in preterm neonates with respiratory distress syndrome (RDS) in a resource-limited setting. The primary outcome was survival or death, and the secondary outcome included complication rates observed among the two groups, HFOV and synchronised intermittent mandatory ventilation (SIMV).Method: Prospective, single-centre, non-crossover, and case-control design comparing outcome of HFOV with synchronised intermittent mandatory ventilation (SIMV) in preterm neonates with RDS.Results: Preterm infants with RDS and a gestational age of 26–36 weeks were ventilated using either SIMV or HFOV soon after intubation. Twenty-two neonates in the HFOV group and 27 in the SIMV group were considered in the final analysis. Mortality was similar in both the groups for each gestational-age subgroup. There were no statistically significant differences in complication rates between the groups.Conclusion: Elective ventilation with HFOV to provide pulmonary support for preterm neonates is feasible in a resource-limited country such as India.