Frequency Oscillatory Ventilation Research Articles

The clinical effects of two non-invasive ventilation modes on premature infants with respiratory distress syndrome: A randomized controlled trial.

To compare the safety and effectiveness of nasal noninvasive high- frequency oscillatory ventilation (NHFOV) and duo positive airway pressure (DuoPAP) applications in preterm babies with respiratory distress syndrome (RDS). This was a randomized controlled trial. Forty-three premature infants with RDS treated in the neonatal intensive care unit of Huaibei Maternal and Child Health Hospital from January 2020 to November 2021 were selected as the research participants. They were randomly divided into the NHFOV group (n = 22) and DuoPAP group (n = 21). General conditions, including the arterial oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2), oxygenation index (OI), the incidence of apnea at 72 hours, duration of noninvasive respiratory support, maternal high-risk factors, total oxygen consumption time, total gastrointestinal feeding time, and the frequency of intraventricular hemorrhage (IVH), neonatal necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD) and apnea were compared between the NHFOV group and DuoPAP group at 12 and 24 hours after noninvasive respiratory support. There was no noteworthy difference between the 2 groups with respect to PaO2, PaCO2, OI, IVH, and NEC and BPD at different nodes (all P > .05). The endpoints of PaO2, PaCO2 and OI and complications of IVH, NEC, BPD and Apnea, and did not reveal any statistical differences between NHFOV and DuoPAP during the respiratory support in preterm babies with RDS.

Nasal Continuous Positive Airway Pressure (NCPAP) Vs Noninvasive Positive Pressure Ventilation (NIPPV) vs Noninvasive High Frequencyoscillation Ventilation (NHFOV) as Post-Extubation Support in Preterm Neonates: A Multi-Center, Randomised, Assessor-Blinded Controlled Trial

Nasal Continuous Positive Airway Pressure (NCPAP) Vs Noninvasive Positive Pressure Ventilation (NIPPV) vs Noninvasive High Frequencyoscillation Ventilation (NHFOV) as Post-Extubation Support in Preterm Neonates: A Multi-Center, Randomised, Assessor-Blinded Controlled Trial

Safety evaluation on different ventilation strategies set for neonatal respiratory distress syndrome: a network Meta-analysis

Objective: To evaluate the relative safety of different ventilation methods regarding mortality and rates of complication, on neonatal respiratory distress syndrome (NRDS). Methods: Network Meta-analysis was used to collect data on randomized controlled trials of pulmonary ventilation strategies in preterm infants with a mean gestational age of less than 32 weeks. Diagnostic criteria on NRDS were published in the PubMed, Cochrane, Web of Science, EBSCO, and Springer Link databases from January 1986 to June 2018. Revman 5.3 software was used to evaluate the quality of studies, based on the Cochrane quality assessment tool. Data were analyzed by Bayesian and frequency methods, using both Win BUGS 1.4.3 and STATA 13.0 software. Safety of different ventilation strategies for NRDS mortality and complications would include intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA) and retinopathy of prematurity (ROP) and were evaluated. Counted data was displayed by OR and 95%CI. Results: A total of 31 RCTs were included in this paper, including 5 827 preterm infants and 11 ventilation strategies. There were no statistically significant differences appearing in 11 ventilation strategies on mortality, PDA or ROP. IVH results were reported in 28 studies. Compared with nasal intermittent positive pressure ventilation (NIPPV), both high- frequency oscillation ventilation (HFOV) (OR=3.33, 95%CI: 1.08-16.67, P<0.05) and synchronized intermittent mechanical ventilation (SIMV) (OR=8.22, 95%CI: 1.25-29.44, P<0.05) schemes seemed to have increased the risk of IVH in preterm infants with NRDS. NIPPV appeared the optimal ventilation strategy in the rankings of cumulative probability. Results on clustering showed that NIPPV was probably the best ventilation strategy for children with NRDS after considering the orders of IVH, PDA and ROP on mortality, respectively. However, HFOV, IMV, and SIMV did not seem to be the ideal ventilated strategies. Conclusions: Most of the clinical decision makers might prefer using NIPPV in the treatment of children with NRDS through mechanical ventilation systems to reduce both the incidence and death caused by IVH, PDA and ROP. It was not recommended to use HFOV, SIMV and IMV in treating NRDS with gestational less than 32 weeks. We suggested that larger numbers of multi-center RCTs ba carried out to make the above conclusions more convincing.

Indication and short term outcome of Mechanical Ventilation in Neonates in a tertiary care hospital

Background: Mechanical ventilation of newborn has been practiced for several years with advances in many ways. As compared to the western world, neonatal ventilation in our country started in recent years.Subjects, Methods and Results: A retrospective chart review was conducted to analyze the common indications and outcome of neonates requiring mechanical ventilation in neonatal intensive care unit at Ad-Din Medical College Hospital from January 2012 to July 2013. Fifty eight neonates were ventilated over a period of 19 months of whom 39 (67.24%) survived. Respiratory distress syndrome was the commonest indication for ventilation (32.75%), followed by Perinatal asphyxia (18.96%), Pneumonia (13.79%), Neonatal Sepsis (13.79%), Meconium aspiration syndrome 6(10.16%) &amp; Pneumothorax 6 (10.16%). Among the babies who survived, 35(89.74%) were managed solely with conventional ventilator and 4 babies required both conventional and High Frequency Oscillatory (HFOV) ventilation. Survival rate was higher where birth weight &gt;2500gm (76.19%) and gestational age 34-37 weeks (88.88%). Survival rates was (69.23%) in &lt;30 weeks and 60% in &lt;1000 g. Prolong ventilator support was needed for Respiratory Distress Syndrome without surfactant (mean 254 hrs), Perinatal asphyxia (mean 187hrs) and Neonatal sepsis (mean 187hrs). Common complications were Pneumonia (12.06%), Pneumothorax (10.34%), sepsis (8.6%) &amp; Pulmonary hemorrhage (3.4%). Survival rate was higher in babies requiring mechanical ventilation for respiratory distress syndrome (84.21%).Conclusion: Use of surfactant could decrease the duration of ventilation and mortality further in babies with respiratory distress syndrome.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.24-28

Lung function at twelve years of age in children born very prematurely

Aim Impaired lung function appears common amongst school children born very prematurely. In one study, 56% of such children had abnormal baseline spirometry at 11 years, but all were born at or Methods Lung function was assessed at 12 years of age in 38 children, the first so far assessed in the follow-up of the randomised, neonatal study of high frequency oscillation versus conventional ventilation (UKOS). Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1:FVC, residual volume (RV), transfer factor for carbon monoxide (TLCO), functional residual capacity (FRC) and response to cold air challenge (CACh) were assessed. Results were considered abnormal if >1.64 standardised residuals (SR) below expected, except RV results which were abnormal if >1.64 SR above expected. The response to the CACh was considered positive if FEV1 fell by >10% of the baseline value post challenge. Results Fifteen children were born between 26 and 28 weeks and 23 between 23 and 25 weeks of gestation. A greater proportion of the “23-25 week” children had been oxygen dependent at 28 days (93% versus 83%, p=0.63) and at discharge (35% versus 17%, p=0.26), in this small sample the differences did not reach statistical significance, but a significantly greater proportion of the “23-25 week” children had received postnatal corticosteroids (60% versus 17%, p=0.013). Overall, the lung function results abnormal in greater than 20% of the study population were FEV1 (24%), TLCO (26%) and RV (34%); 26% of the children had a positive CACh. The two groups, however, did not differ in their weight or height at follow-up, nor in any of the lung function results. Conclusion These preliminary results suggest children born at 26-28 weeks of gestation also suffer lung function impairment at school age and of a similar degree to those born at 23-25 weeks of gestation.

Acoustic Parameters for Optimizing Lung Volume During High- Frequency Oscillatory Ventilation in Infants with Respiratory Distress Syndrome: A Feasibility Study~!2009-08-16~!2009-11-25~!2010-03-05~!

Acoustic Parameters for Optimizing Lung Volume During High- Frequency Oscillatory Ventilation in Infants with Respiratory Distress Syndrome: A Feasibility Study~!2009-08-16~!2009-11-25~!2010-03-05~!

First intention high frequency oscillatory and conventional mechanical ventilation

First intention high frequency oscillatory and conventional mechanical ventilation

Identification of optimal lung volume during high-frequency oscillatory ventilation using respiratory inductive plethysmography.

First, to define the relationships between critical opening and closing pressures and oxygenating efficiency, and second, to address whether respiratory inductive plethysmography (RIP) could be used to monitor changes in thoracic volume that follow changes in mean airway pressure during high- frequency oscillatory ventilation (HFOV). Prospective, interventional animal study. University research laboratory. Five anesthetized, paralyzed, and ventilated pigs. The animals were ventilated by using HFOV after lung injury. Pre- and post-HFOV pressure-volume curves were obtained by supersyringe. A pressure-volume curve was constructed during HFOV as mean airway pressure was increased from 10 to 40 cm H(2)O and then weaned back down to the minimum sustainable. Hemodynamic and oxygenation data were obtained at each data point. RIP-derived thoracic volumes correlated with known lung volumes during supersyringe (r(2) =.78, p <.00001). During HFOV, three of five animals had an identifiable critical opening pressure of the lung, and four of five had an identifiable critical closing pressure. No consistent relationship between critical opening and critical closing pressures was observed. During the weaning phase of HFOV, a relative decrease in RIP-measured volume of >10% predicted the decrease in oxygenation associated with reaching the critical closing pressure. The ability of RIP to detect optimal lung volume during the weaning of mean airway pressure may allow clinicians to more directly monitor lung volume changes during HFOV and use the lowest possible airway pressures after lung recruitment.

High-Frequency Ventilation in Acute Pediatric Respiratory Failure

High-Frequency Ventilation in Acute Pediatric Respiratory Failure