Ventilação de alta freqüência em crianças e adolescentes com síndrome do desconforto respiratório agudo (impacto sobre o uso de ecmo)

Abstract

To assess the effect of high-frequency ventilation (HFV) in children and adolescents with acute respiratory distress syndrome (ARDS) through estimates of survival rate and time of ventilation. To verify whether HFV can reduce the indication for extracorporeal membrane oxygenation (ECMO) in children and adolescents with ARDS. a systematic review of medical literature on the use of HFV and ECMO in children and adolescents with ARDS was carried out. Medline, Lilacs and Embase databases were searched for the following terms: adult respiratory distress syndrome, ARDS, acute respiratory distress syndrome, respiratory distress syndrome, extracorporeal membrane oxygenation, ECMO, high-frequency ventilation, high-frequency jet ventilation and high-frequency oscillatory ventilation. Search was conducted for controlled and randomized clinical trials, cohort studies and a series of cases which compared HFV with conventional mechanic ventilation (CMV), ECMO with CMV, or HFV preceding the use of ECMO. Two hundred eighty nine publications related to HFV, ARDS and ECMO were found. Of these, only nine matched pre-established selection criteria which refer to use of HFV and/or ECMO in children and adolescents with ARDS. It was not possible to determine if use of HFV improves the survival rate of children and adolescent with ARDS. Regarding ventilation time, there is no study that confirms, with statistical significance, its increase or decrease. Whether HFV reduces indication of ECMO for children and adolescents with ARDS or not was also determined.