Non-invasive High-Frequency Oscillatory Ventilation as Initial Respiratory Support for Preterm Infants With Respiratory Distress Syndrome.

Shu-Hua Lai,Luo-Cheng Wu,Zhi-Qing Chen,Rong Chen,Yi-Rong Zheng,Ying-Ling Xie,Wen-Hong Cai,Yun-Feng Lin

doi:10.3389/fped.2021.792160

Abstract

Objectives: The aim of this study was to investigate the safety and feasibility of nHFOV as initial respiratory support in preterm infants with RDS.Methods: This study retrospectively analyzed the clinical data of 244 premature infants with RDS who were treated in our hospital from January 2016 to January 2019 and divided into the nHFOV group (n = 115) and the BiPAP group (n = 129) based on the initial respiratory support method.Results: Respiratory outcomes showed that the rate of NIV failure during the first 72 hours of life in the nHFOV group was significantly lower than that in the BiPAP group. The time of NIV in the nHFOV group was significantly shorter than that in the BiPAP group. The time of supplemental oxygen in the nHFOV group was significantly shorter than that in the BiPAP group. The incidence of air leakage syndrome in the nHFOV group was significantly lower than that in the BiPAP group, and the length of hospital stay of the nHFOV group was also significantly shorter than that in the BiPAP group. Although the rate of infants diagnosed with BPD was similar between the two groups, the rate of severe BPD in the nHFOV group was significantly lower than that in the BiPAP group.Conclusion: This study showed that nHFOV as initial respiratory support for preterm infants with RDS was feasible and safe compared to BiPAP. Furthermore, nHFOV can reduce the need for IMV and reduce the incidence of severe BPD and air leak syndrome.

Highlights

Respiratory distress syndrome (RDS) is one of the most common complications in preterm infants and the most common reason for premature death
The respiratory outcomes showed that the rate of non-invasive ventilation (NIV) failure in the first 72 h of life was significantly lower in the Non-invasive high-frequency oscillatory ventilation (nHFOV) group than in the biphasic positive airway pressure (BiPAP) group (9 vs. 23, P = 0.021)
Studies have shown that nHFOV can reduce the need for invasive mechanical ventilation (IMV) compared to other NIV techniques [12,13,14]

Summary

Introduction

Respiratory distress syndrome (RDS) is one of the most common complications in preterm infants and the most common reason for premature death. A large proportion of preterm infants with RDS require invasive mechanical ventilation (IMV) at an early stage of life. Ventilation is usually life-saving, it can cause many complications, such as air leak syndrome, lung injury, nHFOV for Preterm Infants With RDS and neurodevelopmental impairment [1,2,3]. There are few reports on the application of nHFOV for the treatment of premature infants with RDS. We hypothesized that nHFOV was safe and effective as an initial respiratory support for preterm infants with RDS and had more advantages than BiPAP. We conducted a retrospective controlled study to evaluate the efficacy, safety and advantages of nHFOV for the treatment of premature infants with RDS

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Discussion

Conclusion