Use of noninvasive high-frequency oscillatory ventilation in very low birth weight infants
10.3760/cma.j.issn.0578-1310.2017.03.003
- VernacularTitle: 无创高频振荡通气模式在极低出生体重儿呼吸支持中的应用
- Author:
Chenhong WANG
1
;
Liping SHI
;
Xiaolu MA
;
Huijia LIN
;
Yanping XU
;
Lizhong DU
Author Information
1. Department of Neonatal Intensive Care Unit, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China
- Publication Type:Journal Article
- Keywords:
Infant, very low birth weight;
Bronchopulmonary dysplasia;
High-frequency ventilation;
Noninvasive ventilation
- From:
Chinese Journal of Pediatrics
2017;55(3):177-181
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effectiveness and safety of the use of noninvasive high-frequency oscillation ventilation (nHFOV) in very low birth weight infants.
Method:A total of 36 cases received nHFOV between January 2016 and October 2016 in Children′s Hospital, Zhejiang University School of Medicine, including 24 males and 12 females, with the gestational age of (27.5±2.5) weeks and birth weight of(980±318)g. The data of the ventilator settings, side effects, and changes of the respiratory function before and after nHFOV were collected and analyzed retrospectively. Nonparametric tests or t tests or χ2 tests were used.
Result:Thirty-two (89%) out of the 36 cases successfully avoided intubation or re-intubation after using of nHFOV. nHFOV was used as the rescue treatment after failure of other noninvasive ventilation in 17 cases, and as the prophylactical treatment preventing re-intubation after extubation in the remaining 19 cases. There were significant decreases in the incidences of apnea and desaturation(SpO2<0.85), the level of PaCO2, and the FiO2 24 h after the initiation of the nHFOV as the rescue therapy((1.2±1.1)vs.(6.3±2.1)episodes , (1.1±1.2) vs.(4.3±1.5) episodes, (43±8) vs.(56±10) mmHg, 0.30±0.07 vs. 0.39±0.11, respectively; 1 mmHg=0.133 kPa, t=7.562, 8.913, 4.179, 3.437 respectively, all P<0.01). No significant changes were found in FiO2 and PaCO2 levels 24 h after initiation of nHFOV as the prophylactical therapy after extubation (0.42±0.12 vs.0.40±0.10, (49±8)vs.(48±7)mmHg, t=0.872 and 0.501 respectively, both P>0.05), except for the significant decreases in the mean airway pressure ((7.9±2.6)vs.(9.6±1.6)cmH2O, 1 cmH20=0.098 kPa, t=2.198, P=0.041). There were 4 cases suffered from nasal septum injury, while no other nHFOV related complications were noted.
Conclusion:nHFOV can be applied in preterm infants as a rescue treatment after the failure of other noninvasive ventilation, or prophylactically used in patients who have high risk of re-intubation.
