4,148 results on '"High-frequency ventilation"'
Search Results
2. Reintubation Rate between Nasal High-Frequency Oscillatory Ventilation versus Synchronized Nasal Intermittent Positive Pressure Ventilation in Neonates: A Parallel Randomized Controlled Trial.
- Author
-
Phatigomet, Manapat, Thatrimontrichai, Anucha, Maneenil, Gunlawadee, Dissaneevate, Supaporn, and Janjindamai, Waricha
- Subjects
- *
RESEARCH funding , *STATISTICAL sampling , *NEONATAL intensive care units , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *DESCRIPTIVE statistics , *NEONATAL intensive care , *HIGH-frequency ventilation (Therapy) , *TRACHEA intubation , *REOPERATION , *GESTATIONAL age , *AIRWAY (Anatomy) , *EXTUBATION , *COMPARATIVE studies , *BIRTH weight , *CONFIDENCE intervals , *INTERMITTENT positive pressure breathing , *TIME , *MECHANICAL ventilators - Abstract
Objective Nasal high-frequency oscillatory ventilation (nHFOV) and synchronized nasal intermittent positive pressure ventilation (sNIPPV) were the new modes of noninvasive ventilation. This study's aim was to clarify as to which of the nHFOV and sNIPPV modes was superior in preventing postextubation failure or reintubation in neonates. Study Design An open-label parallel randomized study was performed. Extubated preterm and term neonates were randomly allocated into nHFOV or sNIPPV modes; the reintubation rate was evaluated within 7 days after extubation between the two modes. Subgroup analyses were performed for preterm (gestational age <37 weeks) and very preterm (gestational age <32 weeks) neonates. The sample calculation was 1,050 neonates; however, this trial was stopped early as enrollment was too slow. Results From July 2020 to June 2022, 202 neonates were assessed for eligibility and 69 neonates were excluded. Finally, 133 neonates were randomly allocated to the study interventions (nHFOV = 67, sNIPPV = 66). The median gestational age and birth weight were 33 (30–37) weeks and 1,910 (1,355–2,836) g, respectively. The reintubation rate within 7 days did not significantly differ between the groups (nHFOV [5/67, 7%] vs. sNIPPV [4/66, 6%]); risk difference [95% confidence interval] = 0.01 [−0.08 to 0.11]; p = 0.99), including preterm (nHFOV [4/55, 7%] vs. sNIPPV [3/44, 7%]) and very preterm (nHFOV [3/25, 12%] vs. sNIPPV [3/25, 12%]) neonates. Conclusion After neonatal extubation, there was no significant difference of reintubation rates within 7 days between nHFOV and sNIPPV. This trial has been registered in the ClinicalTrials.gov database (https://clinicaltrials.gov/ct2/show/NCT04323397). First posted registration on March 26, 2020. Key Points There was no significant difference of reintubation rates between nHFOV and sNIPPV. During nHFOV support, one neonate developed pneumomediastinum. During sNIPPV support, one neonate developed pulmonary hemorrhage. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Carbon Dioxide Level between Nasal High-Frequency Oscillatory Ventilation and Synchronized Nasal Intermittent Positive Pressure Ventilation after Extubation in Neonates: A Cross-over Randomized Controlled Trial.
- Author
-
Baingam, Kulthida, Phatigomet, Manapat, Thatrimontrichai, Anucha, Maneenil, Gunlawadee, Dissaneevate, Supaporn, and Janjindamai, Waricha
- Subjects
- *
CONTINUOUS positive airway pressure , *ARTERIAL catheters , *STATISTICAL sampling , *RANDOMIZED controlled trials , *DESCRIPTIVE statistics , *HIGH-frequency ventilation (Therapy) , *CROSSOVER trials , *TRACHEA intubation , *ARTIFICIAL respiration , *EXTUBATION , *CARBON dioxide , *CONFIDENCE intervals , *BIRTH weight , *INTERMITTENT positive pressure breathing , *PARTIAL pressure , *CHILDREN - Abstract
Objective Nasal high-frequency oscillatory ventilation (nHFOV) and synchronized nasal intermittent positive pressure ventilation (sNIPPV) yield a lower partial pressure of carbon dioxide (pCO 2) after extubation than nasal continuous positive airway pressure. Our aim was to clarify which of the two was superior. Study Design We performed a crossover randomized study to evaluate pCO 2 level among 102 participants from July 2020 to June 2022. Intubated preterm and term neonates with arterial lines were randomly allocated to nHFOV–sNIPPV or sNIPPV–nHFOV sequences; their pCO 2 levels were measured after 2 hours in each mode. Subgroup analyses were performed for preterm (gestational age <37 weeks) and very preterm (gestational age <32 weeks) neonates. Results The mean gestational age (nHFOV–sNIPPV, 32.8 vs. sNIPPV–nHFOV, 33.5 weeks) and median birth weight (1,850 vs. 1,930 g) did not differ between the sequences. The mean ± standard deviation pCO 2 level after nHFOV (38.7 ± 8.8 mm Hg) was significantly higher than that after sNIPPV (36.8 ± 10.2 mm Hg; mean difference: 1.9 mm Hg; 95% confidence interval: 0.3–3.4 mm Hg; treatment effect [ p = 0.007] but no sequence [ p = 0.92], period [ p = 0.53], or carryover [ p = 0.94] effects). However, the difference in pCO 2 level between the sequences was not statistically significant in the subgroup analyses of preterm and very preterm neonates. Conclusion After neonatal extubation, the sNIPPV mode was associated with a lower pCO 2 level than the nHFOV mode with no significant difference in preterm and very preterm neonates. Key Points Full noninvasive ventilation support is suggested in neonatal ventilation. pCO 2 level in sNIPPV was lower than in nHFOV. No differences in pCO 2 levels were observed in either preterm or very preterm neonates. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Optimal Strategies of Mechanical Ventilation: Can We Avoid or Reduce Lung Injury?
- Author
-
van Kaam, Anton H.
- Abstract
Despite the increasing use of non-invasive support modalities, many preterm infants still need invasive mechanical ventilation. Mechanical ventilation can lead to so-called ventilator-induced lung injury, which is considered an important risk factor in the development of bronchopulmonary dysplasia. Understanding the concepts of lung protective ventilation strategies is imperative to reduce the risk of BPD.Background: Overdistension, atelectasis, and oxygen toxicity are the most important risk factors for VILI. A lung protective ventilation strategy should therefore optimize lung volume (resolve atelectasis), limit tidal volumes, and reduce oxygen exposure. Executing such a lung protective ventilation strategy requires basic knowledge on neonatal lung physiology. Studies have shown that volume-targeted ventilation (VTV) stabilizes tidal volume delivery, reduces VILI, and reduces BPD in preterm infants with respiratory distress syndrome. High-frequency ventilation (HFV) also reduces BPD although the effect is modest and inconsistent. It is unclear if these benefits also apply to infants with more heterogeneous lung disease.Summary: Understanding basic physiology and the concept of ventilator-induced lung injury is essential in neonatal mechanical ventilation. Current evidence suggests that the principles of lung protective ventilation are best captured by VTV and HFV. [ABSTRACT FROM AUTHOR]Key Messages: - Published
- 2024
- Full Text
- View/download PDF
5. Nasal HFOV Versus Nasal SIPPV in Neonate Following Extubation: RCT Crossover Study (nHFOnSIPPV)
- Author
-
Anucha Thatrimontrichai, Principal Investigator
- Published
- 2023
6. Examining lung mechanical strains as influenced by breathing volumes and rates using experimental digital image correlation
- Author
-
Mariano, CA, Sattari, S, Quiros, KAM, Nelson, TM, and Eskandari, M
- Subjects
Acute Respiratory Distress Syndrome ,Rare Diseases ,Bioengineering ,Lung ,Respiratory ,Animals ,High-Frequency Ventilation ,Humans ,Respiration ,Respiration ,Artificial ,Swine ,Tidal Volume ,Digital image correlation ,Topological strain ,Pulmonary mechanics ,Anisotropy ,Heterogeneity ,Biomechanics ,Ventilation ,Inflation ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Respiratory System - Abstract
BackgroundMechanical ventilation is often employed to facilitate breathing in patients suffering from respiratory illnesses and disabilities. Despite the benefits, there are risks associated with ventilator-induced lung injuries and death, driving investigations for alternative ventilation techniques to improve mechanical ventilation, such as multi-oscillatory and high-frequency ventilation; however, few studies have evaluated fundamental lung mechanical local deformations under variable loading.MethodsPorcine whole lung samples were analyzed using a novel application of digital image correlation interfaced with an electromechanical ventilation system to associate the local behavior to the global volume and pressure loading in response to various inflation volumes and breathing rates. Strains, anisotropy, tissue compliance, and the evolutionary response of the inflating lung were analyzed.ResultsExperiments demonstrated a direct and near one-to-one linear relationship between applied lung volumes and resulting local mean strain, and a nonlinear relationship between lung pressures and strains. As the applied air delivery volume was doubled, the tissue surface mean strains approximately increased from 20 to 40%, and average maximum strains measured 70-110%. The tissue strain anisotropic ratio ranged from 0.81 to 0.86 and decreased with greater inflation volumes. Local tissue compliance during the inflation cycle, associating evolutionary strains in response to inflation pressures, was also quantified.ConclusionVentilation frequencies were not found to influence the local stretch response. Strain measures significantly increased and the anisotropic ratio decreased between the smallest and greatest tidal volumes. Tissue compliance did not exhibit a unifying trend. The insights provided by the real-time continuous measures, and the kinetics to kinematics pulmonary linkage established by this study offers valuable characterizations for computational models and establishes a framework for future studies to compare healthy and diseased lung mechanics to further consider alternatives for effective ventilation strategies.
- Published
- 2022
7. Receipt of high-frequency ventilation is associated with acute kidney injury in very preterm neonates.
- Author
-
Haynes, Nicholas, Bell, Jeremiah, Griffin, Russel, Askenazi, David J., Jetton, Jennifer, Kent, Alison L., for the Neonatal Kidney Collaborative, Selewski, David T., Sarkar, Subrata, Fletcher, Jeffery, Abitbol, Carolyn L., DeFreitas, Marissa, Duara, Shahnaz, Charlton, Jennifer R., Swanson, Jonathan R., Guillet, Ronnie, D'Angio, Carl, Mian, Ayesa, Rademacher, Erin, and Mhanna, Maroun J.
- Subjects
- *
NEONATAL intensive care , *CONFIDENCE intervals , *NEONATAL diseases , *RETROSPECTIVE studies , *ACQUISITION of data , *NEONATAL intensive care units , *COMPARATIVE studies , *RISK assessment , *HIGH-frequency ventilation (Therapy) , *MEDICAL records , *DESCRIPTIVE statistics , *ACUTE kidney failure , *LONGITUDINAL method , *DISEASE risk factors - Abstract
Background: High-frequency ventilation (HFV) is frequently used in critically ill preterm neonates. We aimed to determine the incidence of acute kidney injury (AKI) in neonates less than 29 weeks gestation who received HFV in the first week of life and to determine if the rates of AKI differed in those who received other forms of respiratory support. Methods: This retrospective cohort study of 24 international, level III/IV neonatal intensive care units (NICUs) included neonates less than 29 weeks gestation from the AWAKEN study database. Exclusion criteria included the following: no intravenous fluids ≥ 48 h, admission ≥ 14 days of life, congenital heart disease requiring surgical repair at < 7 days of life, lethal chromosomal anomaly, death within 48 h, severe congenital kidney abnormalities, inability to determine AKI status, insufficient data on ventilation, and when the diagnosis of early AKI was unable to be made. Subjects were grouped into three groups based on ventilation modes (CPAP/no ventilation, conventional ventilation, and HFV). Results: The incidence of AKI was highest in the CPAP/no ventilation group, followed by HFV, followed by conventional ventilation (CPAP/no ventilation 48.5% vs. HFV 42.6% vs. conventional ventilation 28.4% (p = 0.009). An increased risk for AKI was found for those on HFV compared to CPAP/no ventilation (HR = 2.65; 95% CI:1.22–5.73). Conclusions: HFV is associated with AKI in the first week of life. Neonates on HFV should be screened for AKI. The reasons for this association are not clear. Further studies should evaluate the relationship between ventilator strategies and AKI in premature neonates. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
8. Beatmung in der Neonatologie – Wie können Schäden vermieden werden?
- Author
-
Herting, Egbert and Humberg, Alexander
- Abstract
Copyright of Monatsschrift Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
- Full Text
- View/download PDF
9. Effects of high frequency non-invasive ventilation in premature newborn infants: systematic review protocol.
- Author
-
Tolosa dos Santos, Emanuelle, Lima de Oliveira, Luiani, de Siqueira Barros Nogueira, Fernanda Gabriella, Lima Monteiro, Renan, Rego Fagury, Samira Vitória, Pereira Nunes Pinto, Ana Carolina, and Rodrigues do Amaral, Juliana Anézia
- Subjects
PREMATURE infants ,SYSTEMATIC reviews ,TREATMENT effectiveness ,ARTIFICIAL respiration ,HIGH-frequency ventilation (Therapy) ,PATIENT safety ,EVALUATION ,CHILDREN - Abstract
Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
10. High-Frequency Ventilation: General Concepts
- Author
-
Bunnell, J. Bert, Donn, Steven M., editor, Mammel, Mark C., editor, and van Kaam, Anton H.L.C., editor
- Published
- 2022
- Full Text
- View/download PDF
11. Selection of the Best Neonatal Ventilator in Patients with COVID-19 Using Multicriteria Analysis
- Author
-
Ochoa-Ortiz, Alberto, Cruz-Mejía, Oliverio, Mejia, José, Chatterjee, Prasenjit, Series Editor, Awasthi, Anjali, Series Editor, Tiwari, Manoj Kumar, Series Editor, Chakraborty, Shankar, Series Editor, Yazdani, Morteza, Series Editor, Kose, Utku, editor, Watada, Junzo, editor, Deperlioglu, Omer, editor, and Marmolejo Saucedo, Jose Antonio, editor
- Published
- 2022
- Full Text
- View/download PDF
12. Regular lung recruitment maneuvers during high-frequency oscillatory ventilation in extremely preterm infants: a randomized controlled trial
- Author
-
Tobias Werther, Erik Kueng, Lukas Aichhorn, Linda Pummer, Katharina Goeral, Angelika Berger, Michael Hermon, and Katrin Klebermass-Schrehof
- Subjects
Neonatal intensive care unit ,Extremely premature infant ,Oxygen Saturation ,Lung volume ,High-frequency ventilation ,Respiratory distress syndrome ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Lung recruitment maneuvers (LRMs) improve lung volume at initiation of high-frequency oscillatory ventilation (HFOV), but it is unclear when to repeat LRMs. We evaluated the efficiency of scheduled LRMs. Methods In a randomized controlled trial, extremely preterm infants on HFOV received either LRMs at 12-hour intervals and when clinically indicated (intervention) or only when clinically indicated (control). The primary outcome was the cumulative oxygen saturation index (OSI) over HFOV time, limited to 7 days. Additionally, LRMs were analyzed with respect to OSI improvement. Results Fifteen infants were included in each group. The mean (SD) postmenstrual age and weight at HFOV start were 23 + 6 (0 + 5) weeks and 650 (115) g in the intervention group and 24 + 4 (0 + 6) weeks (p = 0.03) and 615 (95) g (p = 0.38) in the control group. The mean (SD) cumulative OSI amounted to 4.95 (1.72) in the intervention versus 5.30 (2.08) in the control group (p = 0.61). The mean (SD) number of LRMs in 12 h was 1.3 (0.2) in the intervention versus 1.1 (0.5) in the control group (p = 0.13). Performing LRM when FiO2 > 0.6 resulted in a mean OSI reduction of 3.6. Conclusion Regular versus clinically indicated LRMs were performed with equal frequency in preterm infants during HFOV, and consequently, no difference in lung volume was observed. LRMs seem to be most efficient at high FiO2. Trial registration ClinicalTrials.gov ID: NCT04289324 (28/02/2020).
- Published
- 2022
- Full Text
- View/download PDF
13. Acute respiratory distress syndrome.
- Author
-
Matthay, Michael A, Zemans, Rachel L, Zimmerman, Guy A, Arabi, Yaseen M, Beitler, Jeremy R, Mercat, Alain, Herridge, Margaret, Randolph, Adrienne G, and Calfee, Carolyn S
- Subjects
Humans ,Respiratory Distress Syndrome ,Adult ,Carbon Dioxide ,Angiopoietin-2 ,von Willebrand Factor ,Cadherins ,Interleukin-8 ,Vasodilator Agents ,Antigens ,CD ,Glucocorticoids ,Radiography ,Respiration ,Artificial ,High-Frequency Ventilation ,Positive-Pressure Respiration ,Quality of Life ,Ventilator-Induced Lung Injury ,Biomarkers ,Antigens ,CD ,Respiration ,Artificial ,Respiratory Distress Syndrome ,Adult ,Clinical Sciences - Abstract
The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients and is defined by the acute onset of noncardiogenic pulmonary oedema, hypoxaemia and the need for mechanical ventilation. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma and is present in ~10% of all patients in intensive care units worldwide. Despite some improvements, mortality remains high at 30-40% in most studies. Pathological specimens from patients with ARDS frequently reveal diffuse alveolar damage, and laboratory studies have demonstrated both alveolar epithelial and lung endothelial injury, resulting in accumulation of protein-rich inflammatory oedematous fluid in the alveolar space. Diagnosis is based on consensus syndromic criteria, with modifications for under-resourced settings and in paediatric patients. Treatment focuses on lung-protective ventilation; no specific pharmacotherapies have been identified. Long-term outcomes of patients with ARDS are increasingly recognized as important research targets, as many patients survive ARDS only to have ongoing functional and/or psychological sequelae. Future directions include efforts to facilitate earlier recognition of ARDS, identifying responsive subsets of patients and ongoing efforts to understand fundamental mechanisms of lung injury to design specific treatments.
- Published
- 2019
14. Evaluation of Prolonged Apnea Supported by High Frequency Non-invasive Ventilation. (ANIV)
- Author
-
Adam Ogna, MD
- Published
- 2020
15. MRI of the Chest Under High Frequency Ventilation
- Author
-
Beigelman-Aubry Catherine, MD
- Published
- 2020
16. Regular lung recruitment maneuvers during high-frequency oscillatory ventilation in extremely preterm infants: a randomized controlled trial.
- Author
-
Werther, Tobias, Kueng, Erik, Aichhorn, Lukas, Pummer, Linda, Goeral, Katharina, Berger, Angelika, Hermon, Michael, and Klebermass-Schrehof, Katrin
- Subjects
HIGH-frequency ventilation (Therapy) ,PREMATURE infants ,RANDOMIZED controlled trials ,LUNG volume ,NEONATAL intensive care units - Abstract
Background: Lung recruitment maneuvers (LRMs) improve lung volume at initiation of high-frequency oscillatory ventilation (HFOV), but it is unclear when to repeat LRMs. We evaluated the efficiency of scheduled LRMs. Methods: In a randomized controlled trial, extremely preterm infants on HFOV received either LRMs at 12-hour intervals and when clinically indicated (intervention) or only when clinically indicated (control). The primary outcome was the cumulative oxygen saturation index (OSI) over HFOV time, limited to 7 days. Additionally, LRMs were analyzed with respect to OSI improvement. Results: Fifteen infants were included in each group. The mean (SD) postmenstrual age and weight at HFOV start were 23 + 6 (0 + 5) weeks and 650 (115) g in the intervention group and 24 + 4 (0 + 6) weeks (p = 0.03) and 615 (95) g (p = 0.38) in the control group. The mean (SD) cumulative OSI amounted to 4.95 (1.72) in the intervention versus 5.30 (2.08) in the control group (p = 0.61). The mean (SD) number of LRMs in 12 h was 1.3 (0.2) in the intervention versus 1.1 (0.5) in the control group (p = 0.13). Performing LRM when FiO2 > 0.6 resulted in a mean OSI reduction of 3.6. Conclusion: Regular versus clinically indicated LRMs were performed with equal frequency in preterm infants during HFOV, and consequently, no difference in lung volume was observed. LRMs seem to be most efficient at high FiO2. Trial registration: ClinicalTrials.gov ID: NCT04289324 (28/02/2020). [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
17. 2021 Year in Review: Pediatric Mechanical Ventilation.
- Author
-
Miller, Andrew G. and Scott, Briana L.
- Subjects
LUNG physiology ,INTENSIVE care units ,EVALUATION of medical care ,ENDOTRACHEAL suctioning ,LUNG volume measurements ,RESPIRATORY insufficiency ,ANESTHESIA ,PRESSURE breathing ,PEDIATRICS ,OXYGEN saturation ,ARTIFICIAL respiration ,EXTUBATION ,MUSIC therapy ,BRONCHIOLE diseases ,REACTIVE oxygen species ,PULMONARY gas exchange ,OXYGEN in the body - Abstract
Mechanical ventilation is commonly used in the pediatric intensive care unit. This paper reviews studies of pediatric mechanical ventilation published in 2021. Topics include physiology, ventilator modes, alarms, disease states, airway suctioning, ventilator liberation, prolonged ventilation, and others. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
18. Definitive Closure of the Patent Ductus Arteriosus in Preterm Infants and Subsequent Short-Term Respiratory Outcomes.
- Author
-
Wheeler, Craig R., Vogel, Elizabeth R., Cusano, Michael A., Friedman, Kevin G., Callahan, Ryan, Porras, Diego, Ibla, Juan C., and Levy, Philip T.
- Subjects
PATENT ductus arteriosus ,MINIMALLY invasive procedures ,RESPIRATORY infections ,ANGINA pectoris ,TREATMENT effectiveness ,ARTIFICIAL respiration ,HEMODYNAMICS ,CATHETERIZATION ,DISEASE risk factors - Abstract
A persistent patent ductus arteriosus (PDA) can have significant clinical consequences in pre-term infants, depending on the degree of left-to-right shunting, its impact on cardiac performance, and associated perinatal risk factors that can mitigate or exacerbate the shunt. Although the best management strategy remains contentious, PDAs that have contraindications to, or have failed medical management have historically undergone surgical ligation. Recently smaller occluder devices and delivery systems have allowed for minimally invasive closure in the catheterization laboratory even in extremely premature infants. The present review summarizes the pathophysiologic manifestations, treatment options and management of hemodynamically significant PDA in preterm infants. Additionally, we review the available literature surrounding the respiratory support and outcomes of preterm infants following definitive PDA closure. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
19. The Physiological Basis of High-Frequency Oscillatory Ventilation and Current Evidence in Adults and Children: A Narrative Review.
- Author
-
Miller, Andrew G., Tan, Herng Lee, Smith, Brian J., Rotta, Alexandre T., and Lee, Jan Hau
- Subjects
HIGH-frequency ventilation (Therapy) ,CRITICALLY ill ,ADULTS ,ADULT respiratory distress syndrome ,RESPIRATORY organs ,ARTIFICIAL respiration - Abstract
High-frequency oscillatory ventilation (HFOV) is a type of invasive mechanical ventilation that employs supra-physiologic respiratory rates and low tidal volumes (V
T ) that approximate the anatomic deadspace. During HFOV, mean airway pressure is set and gas is then displaced towards and away from the patient through a piston. Carbon dioxide (CO2 ) is cleared based on the power (amplitude) setting and frequency, with lower frequencies resulting in higher VT and CO2 clearance. Airway pressure amplitude is significantly attenuated throughout the respiratory system and mechanical strain and stress on the alveoli are theoretically minimized. HFOV has been purported as a form of lung protective ventilation that minimizes volutrauma, atelectrauma, and biotrauma. Following two large randomized controlled trials showing no benefit and harm, respectively, HFOV has largely been abandoned in adults with ARDS. A multi-center clinical trial in children is ongoing. This article aims to review the physiologic rationale for the use of HFOV in patients with acute respiratory failure, summarize relevant bench and animal models, and discuss the potential use of HFOV as a primary and rescue mode in adults and children with severe respiratory failure. [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
- View/download PDF
20. Comparison of High Frequency Jet Ventilation and Conventional Positive Pressure Ventilation for Endobronchial Ultrasound Examinations.
- Abstract
This document provides information about a clinical trial, NCT06537388, comparing two methods of ventilation for endobronchial ultrasound (EBUS) examinations. The trial aims to analyze complications associated with high frequency jet ventilation (HFJV) and conventional intermittent positive pressure ventilation (IPPV). The document also includes several publications related to high-frequency ventilation and bronchoscopy, including case reports, systematic reviews, and randomized controlled trials. Additionally, it provides recruitment information for a study on endobronchial ultrasound-guided transbronchial needle aspiration using HFJV or IPPV, which aims to enroll 300 participants. Administrative information, such as the NCT number and contact information for primary and backup contacts, is also provided. [Extracted from the article]
- Published
- 2024
21. Findings from Massachusetts General Hospital in the Area of Pneumothorax Reported (High-frequency Jet Ventilation Versus Spontaneous Respiration for Percutaneous Cryoablation of Lung Tumors: Comparison of Adverse Events and Procedural Efficiency).
- Subjects
HIGH-frequency ventilation (Therapy) ,PNEUMOTHORAX ,LUNG tumors ,CRYOSURGERY ,RESPIRATION ,RESPIRATORY diseases - Abstract
The article discusses research by Florian J. Fintelmann from Massachusetts General Hospital and, reported in the American Journal of Roentgenology issue, on August 19, 2024. The study compares high-frequency jet ventilation (HFJV) and spontaneous respiration (SR) for percutaneous cryoablation of lung tumors, evaluating their impact on procedural efficiency and adverse events. Topics include procedural time and efficiency, adverse event rates, and the incidence of pneumothorax.
- Published
- 2024
22. Studies in the Area of Bronchoscopy Reported from Southeast University (Effectiveness and Safety of Superimposed High-Frequency Jet Ventilation in Rigid Bronchoscopy: A Single-Center, Retrospective Study).
- Abstract
A recent study conducted by researchers at Southeast University in Nanjing, China, examined the effectiveness and safety of superimposed high-frequency jet ventilation (SHFJV) in rigid bronchoscopy. The study included 363 patients, divided into two groups based on the presence or absence of airway stenosis. The researchers found that SHFJV was effective and safe for patients with airway stenosis and preoperative cardiovascular disease, making it a suitable airway management strategy for rigid bronchoscopy. The study also noted that patients with severe airway stenosis had longer procedure durations compared to those with mild to moderate stenosis. [Extracted from the article]
- Published
- 2024
23. Feasibility, Safety, and Short‐Term Outcomes of Transcatheter Patent Ductus Arteriosus Closure in Premature Infants on High‐Frequency Jet Ventilation
- Author
-
Kamel Shibbani, Bassel Mohammad Nijres, Daniel McLennan, Adrianne Rahde Bischoff, Regan Giesinger, Patrick J. McNamara, Jonathan Klein, Jimmy Windsor, and Osamah Aldoss
- Subjects
device closure ,high‐frequency jet ventilator ,high‐frequency ventilation ,patent ductus arteriosus ,transcatheter ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Prolonged exposure to a hemodynamically significant patent ductus arteriosus (PDA) is associated with major morbidity, particularly in infants born at
- Published
- 2022
- Full Text
- View/download PDF
24. The Physiological Basis of High-Frequency Oscillatory Ventilation and Current Evidence in Adults and Children: A Narrative Review
- Author
-
Andrew G. Miller, Herng Lee Tan, Brian J. Smith, Alexandre T. Rotta, and Jan Hau Lee
- Subjects
mechanical ventilation (lung protection) strategy ,high-frequency ventilation with oscillations ,high-frequency ventilation ,children ,ARDS ,review (article) ,Physiology ,QP1-981 - Abstract
High-frequency oscillatory ventilation (HFOV) is a type of invasive mechanical ventilation that employs supra-physiologic respiratory rates and low tidal volumes (VT) that approximate the anatomic deadspace. During HFOV, mean airway pressure is set and gas is then displaced towards and away from the patient through a piston. Carbon dioxide (CO2) is cleared based on the power (amplitude) setting and frequency, with lower frequencies resulting in higher VT and CO2 clearance. Airway pressure amplitude is significantly attenuated throughout the respiratory system and mechanical strain and stress on the alveoli are theoretically minimized. HFOV has been purported as a form of lung protective ventilation that minimizes volutrauma, atelectrauma, and biotrauma. Following two large randomized controlled trials showing no benefit and harm, respectively, HFOV has largely been abandoned in adults with ARDS. A multi-center clinical trial in children is ongoing. This article aims to review the physiologic rationale for the use of HFOV in patients with acute respiratory failure, summarize relevant bench and animal models, and discuss the potential use of HFOV as a primary and rescue mode in adults and children with severe respiratory failure.
- Published
- 2022
- Full Text
- View/download PDF
25. Unsuccessful and Successful Clinical Trials in Acute Respiratory Distress Syndrome: Addressing Physiology-Based Gaps.
- Author
-
Villar, Jesús, Ferrando, Carlos, Tusman, Gerardo, Berra, Lorenzo, Rodríguez-Suárez, Pedro, and Suárez-Sipmann, Fernando
- Subjects
ADULT respiratory distress syndrome ,ETIOLOGY of diseases ,POSITIVE end-expiratory pressure ,HIGH-frequency ventilation (Therapy) ,CLINICAL trials ,INTERSTITIAL lung diseases ,CARDIOGENIC shock - Abstract
The acute respiratory distress syndrome (ARDS) is a severe form of acute hypoxemic respiratory failure caused by an insult to the alveolar-capillary membrane, resulting in a marked reduction of aerated alveoli, increased vascular permeability and subsequent interstitial and alveolar pulmonary edema, reduced lung compliance, increase of physiological dead space, and hypoxemia. Most ARDS patients improve their systemic oxygenation, as assessed by the ratio between arterial partial pressure of oxygen and inspired oxygen fraction, with conventional intensive care and the application of moderate-to-high levels of positive end-expiratory pressure. However, in some patients hypoxemia persisted because the lungs are markedly injured, remaining unresponsive to increasing the inspiratory fraction of oxygen and positive end-expiratory pressure. For decades, mechanical ventilation was the only standard support technique to provide acceptable oxygenation and carbon dioxide removal. Mechanical ventilation provides time for the specific therapy to reverse the disease-causing lung injury and for the recovery of the respiratory function. The adverse effects of mechanical ventilation are direct consequences of the changes in pulmonary airway pressures and intrathoracic volume changes induced by the repetitive mechanical cycles in a diseased lung. In this article, we review 14 major successful and unsuccessful randomized controlled trials conducted in patients with ARDS on a series of techniques to improve oxygenation and ventilation published since 2010. Those trials tested the effects of adjunctive therapies (neuromuscular blocking agents, prone positioning), methods for selecting the optimum positive end-expiratory pressure (after recruitment maneuvers, or guided by esophageal pressure), high-frequency oscillatory ventilation, extracorporeal oxygenation, and pharmacologic immune modulators of the pulmonary and systemic inflammatory responses in patients affected by ARDS. We will briefly comment physiology-based gaps of negative trials and highlight the possible needs to address in future clinical trials in ARDS. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
26. High-Frequency Jet Ventilation in Infants With Congenital Heart Disease.
- Author
-
Miller, Andrew G., Scott, Briana L., Gates, Rachel M., Haynes, Kaitlyn E., Lopez Domowicz, Denise A., and Rotta, Alexandre T.
- Subjects
INTENSIVE care units ,RESPIRATORY insufficiency ,ACQUISITION of data methodology ,CONGENITAL heart disease ,RETROSPECTIVE studies ,EXTRACORPOREAL membrane oxygenation ,ARTIFICIAL respiration ,MEDICAL records ,NITRIC oxide ,PULMONARY gas exchange ,CHILDREN - Abstract
BACKGROUND: High-frequency jet ventilation (HFJV) is primarily used in neonates but may also have a role in the treatment of infants with congenital heart disease and severe respiratory failure. We hypothesized that HFJV would result in improved gas exchange in these infants. METHODS: We retrospectively reviewed the records of all pediatric patients with complex congenital heart disease treated HFJV in our pediatric cardiac ICU between 2014 and 2018. Patients in whom HFJV was started while on extracorporeal membrane oxygenation (ECMO) were excluded. We extracted data on demographics, pulmonary mechanics, gas exchange, the subsequent need for ECMO, use of inhaled nitric oxide, and outcomes. RESULTS: We included 27 subjects (median [interquartile range {IQR}] weight 4.4 [3.3-5.4] kg; median [IQR] age 2.5 [0.3-5.4] months), 22 (82%) of whom had cyanotic heart disease. Thirteen subjects (48%) survived and 6 (22%) required ECMO. HFJV was started after a median (IQR) of 8.4 (2.1-26.3) d of conventional mechanical ventilation. The subjects spent a median (IQR) of 1.2 (0.5-2.8) d on HFJV. The median (IQR) pre-HFJV blood gas results (n = 25) were pH 7.22 (7.17-7.31), P
a CO2 69 (51-77) mm Hg, and Pa O2 51 (41-76) mm Hg. Median (IQR) initial HFJV settings were peak inspiratory pressure of 45 (36-50) cm H2 O, breathing frequency of 360 (360-380) breaths/min, and inspiratory time of 0.02 (0.02-0.03) s. Compared with conventional mechanical ventilation, at 4-6 h after HFJV initiation, there were significant improvements in the median pH (7.22 vs 7.34; P = .001) and Pa CO2 (69 vs 50 mm Hg; P = .001), respectively, but no difference in median Pa O2 (51 vs 53 mm Hg; P = .97). CONCLUSIONS: HFJV was associated with a decrease in Pa CO2 and an increase in pH in infants with congenital heart disease who remained on HFJV 4 to 6 h after initiation. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
27. The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome
- Author
-
Judith Ju-Ming Wong, Siqi Liu, Hongxing Dang, Nattachai Anantasit, Phuc Huu Phan, Suwannee Phumeetham, Suyun Qian, Jacqueline Soo May Ong, Chin Seng Gan, Yek Kee Chor, Rujipat Samransamruajkit, Tsee Foong Loh, Mengling Feng, Jan Hau Lee, and for the Pediatric Acute & Critical care Medicine Asian Network (PACCMAN)
- Subjects
High-frequency ventilation ,Mechanical ventilation ,Acute respiratory distress syndrome ,Acute lung injury ,Paediatric intensive care unit ,Children ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background High-frequency oscillatory ventilation (HFOV) use was associated with greater mortality in adult acute respiratory distress syndrome (ARDS). Nevertheless, HFOV is still frequently used as rescue therapy in paediatric acute respiratory distress syndrome (PARDS). In view of the limited evidence for HFOV in PARDS and evidence demonstrating harm in adult patients with ARDS, we hypothesized that HFOV use compared to other modes of mechanical ventilation is associated with increased mortality in PARDS. Methods Patients with PARDS from 10 paediatric intensive care units across Asia from 2009 to 2015 were identified. Data on epidemiology and clinical outcomes were collected. Patients on HFOV were compared to patients on other modes of ventilation. The primary outcome was 28-day mortality and secondary outcomes were 28-day ventilator- (VFD) and intensive care unit- (IFD) free days. Genetic matching (GM) method was used to analyse the association between HFOV treatment with the primary outcome. Additionally, we performed a sensitivity analysis, including propensity score (PS) matching, inverse probability of treatment weighting (IPTW) and marginal structural modelling (MSM) to estimate the treatment effect. Results A total of 328 patients were included. In the first 7 days of PARDS, 122/328 (37.2%) patients were supported with HFOV. There were significant differences in baseline oxygenation index (OI) between the HFOV and non-HFOV groups (18.8 [12.0, 30.2] vs. 7.7 [5.1, 13.1] respectively; p
- Published
- 2020
- Full Text
- View/download PDF
28. Unsuccessful and Successful Clinical Trials in Acute Respiratory Distress Syndrome: Addressing Physiology-Based Gaps
- Author
-
Jesús Villar, Carlos Ferrando, Gerardo Tusman, Lorenzo Berra, Pedro Rodríguez-Suárez, and Fernando Suárez-Sipmann
- Subjects
acute respiratory distress syndrome ,clinical trials ,neuromuscular blockade ,prone ventilation ,high-frequency ventilation ,positive end-expiratory pressure ,Physiology ,QP1-981 - Abstract
The acute respiratory distress syndrome (ARDS) is a severe form of acute hypoxemic respiratory failure caused by an insult to the alveolar-capillary membrane, resulting in a marked reduction of aerated alveoli, increased vascular permeability and subsequent interstitial and alveolar pulmonary edema, reduced lung compliance, increase of physiological dead space, and hypoxemia. Most ARDS patients improve their systemic oxygenation, as assessed by the ratio between arterial partial pressure of oxygen and inspired oxygen fraction, with conventional intensive care and the application of moderate-to-high levels of positive end-expiratory pressure. However, in some patients hypoxemia persisted because the lungs are markedly injured, remaining unresponsive to increasing the inspiratory fraction of oxygen and positive end-expiratory pressure. For decades, mechanical ventilation was the only standard support technique to provide acceptable oxygenation and carbon dioxide removal. Mechanical ventilation provides time for the specific therapy to reverse the disease-causing lung injury and for the recovery of the respiratory function. The adverse effects of mechanical ventilation are direct consequences of the changes in pulmonary airway pressures and intrathoracic volume changes induced by the repetitive mechanical cycles in a diseased lung. In this article, we review 14 major successful and unsuccessful randomized controlled trials conducted in patients with ARDS on a series of techniques to improve oxygenation and ventilation published since 2010. Those trials tested the effects of adjunctive therapies (neuromuscular blocking agents, prone positioning), methods for selecting the optimum positive end-expiratory pressure (after recruitment maneuvers, or guided by esophageal pressure), high-frequency oscillatory ventilation, extracorporeal oxygenation, and pharmacologic immune modulators of the pulmonary and systemic inflammatory responses in patients affected by ARDS. We will briefly comment physiology-based gaps of negative trials and highlight the possible needs to address in future clinical trials in ARDS.
- Published
- 2021
- Full Text
- View/download PDF
29. Foreign Body in the Airway Mimicking Tumour in an Adult: A Case Report.
- Author
-
Šimon R, Šimonová J, Čuchrač L, Klimčík R, and Vašková J
- Abstract
Foreign body (FB) aspiration is an infrequent cause of respiratory distress in adults. Advancing age, central nervous system disorders or trauma, drug or alcohol addiction, neuromuscular diseases, and mental health issues and illnesses are the main risk factors. The authors present an atypical clinical presentation of a 3-week-lasting foreign body aspiration mimicking a tumour that led to severe acute respiratory insufficiency and required aggressive artificial lung ventilation. Diagnosis of FB was based on the results of the chest computed tomography (CT) scans and flexible bronchoscopy, which, however, initially assumed a neoplastic disease in the right main bronchus. During FB extraction via flexible fiberoptic bronchoscopy inserted through an 8.5 mm endotracheal tube high-frequency ventilation through a catheter placed between the vocal cords was used to ensure adequate alveolar ventilation and maintain sufficient oxygenation. After extraction of the FB, thoracosurgical intervention was performed to resolve empyema as a septic complication of the FB aspiration. After this therapy, a complete resolution of pleural empyema and lung atelectasis was observed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Šimon et al.)
- Published
- 2024
- Full Text
- View/download PDF
30. Transcatheter patent ductus arteriosus closure in premature infants requiring high-frequency ventilation.
- Author
-
Dalby ST, Courtney SE, Sharma M, and Angtuaco MJ
- Abstract
Transcatheter closure has become a common treatment method for patent ductus arteriosus in premature infants at many centres; however, many remain uncertain about the ability to perform the procedure in the catheterisation laboratory for infants requiring high-frequency ventilation. This study presents our centre's experience following the implementation of neonatal ventilatory guidelines, which resulted in 100% procedural success without any procedural or respiratory adverse events.
- Published
- 2024
- Full Text
- View/download PDF
31. Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography.
- Author
-
Herrmann, Jacob, Gerard, Sarah E., Reinhardt, Joseph M., Hoffman, Eric A., and Kaczka, David W.
- Abstract
Enhanced intrapulmonary gas transport enables oscillatory ventilation modalities to support gas exchange using extremely low tidal volumes at high frequencies. However, it is unknown whether gas transport rates can be improved by combining multiple frequencies of oscillation simultaneously. The goal of this study was to investigate distributed gas transport in vivo during multi-frequency oscillatory ventilation (MFOV) as compared with conventional mechanical ventilation (CMV) or high-frequency oscillatory ventilation (HFOV). We hypothesized that MFOV would result in more uniform rates of gas transport compared to HFOV, measured using contrast-enhanced CT imaging during wash-in of xenon gas. In 13 pigs, xenon wash-in equilibration rates were comparable between CMV and MFOV, but 21 to 39% slower for HFOV. By contrast, the root-mean-square delivered volume was lowest for MFOV, increased by 70% during HFOV and 365% during CMV. Overall gas transport heterogeneity was similar across all modalities, but gravitational gradients and regional patchiness of specific ventilation contributed to regional ventilation heterogeneity, depending on ventilator modality. We conclude that MFOV combines benefits of low lung stretch, similar to HFOV, but with fast rates of gas transport, similar to CMV. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
32. Studies from Beth Israel Deaconess Medical Center Add New Findings in the Area of Atrial Fibrillation (Recovery and Safety With Prolonged High-frequency Jet Ventilation for Catheter Ablation of Atrial Fibrillation: a Hospital Registry Study...).
- Subjects
ATRIAL fibrillation ,CATHETER ablation ,MEDICAL centers ,HIGH-frequency ventilation (Therapy) ,CRITICAL care medicine ,ARRHYTHMIA - Abstract
A study conducted at Beth Israel Deaconess Medical Center in Boston, Massachusetts investigated the use of high-frequency jet ventilation (HFJV) versus conventional ventilation in patients undergoing catheter ablation for atrial fibrillation. The study found that patients who received HFJV had a longer post-anesthesia care unit (PACU) length of stay compared to those who received conventional mechanical ventilation. Additionally, patients undergoing HFJV had a higher risk of intra-procedural hypocarbia and hypotension. However, there was no association between HFJV and intra-procedural hypoxemia or post-procedural respiratory complications. The study suggests that HFJV for catheter ablation procedures for atrial fibrillation may be associated with a longer PACU stay and an increased risk of certain abnormalities. [Extracted from the article]
- Published
- 2024
33. The impact of steady streaming and conditional turbulence on gas transport during high-frequency ventilation.
- Author
-
Jacob, Chinthaka, Tingay, David G., and Leontini, Justin S.
- Subjects
- *
TURBULENT shear flow , *TURBULENCE , *ARTIFICIAL respiration , *STREAMFLOW , *INFANTS - Abstract
High-frequency ventilation is a type of mechanical ventilation therapy applied on patients with damaged or delicate lungs. However, the transport of oxygen down, and carbon dioxide up, the airway is governed by subtle transport processes which hitherto have been difficult to quantify. We investigate one of these mechanisms in detail, nonlinear mean streaming, and the impact of the onset of turbulence on this streaming, via direct numerical simulations of a model 1:2 bifurcating pipe. This geometry is investigated as a minimal unit of the fractal structure of the airway. We first quantify the amount of gas recirculated via mean streaming by measuring the recirculating flux in both the upper and lower branches of the bifurcation. For conditions modeling the trachea-to-bronchi bifurcation of an infant, we find the recirculating flux is of the order of 3–5% of the peak flux. We also show that for conditions modeling the upper generations, the mean recirculation regions extend a significant distance away from the bifurcation, certainly far enough to recirculate gas between generations. We show that this mean streaming flow is driven by the formation of longitudinal vortices in the flow leaving the bifurcation. Second, we show that conditional turbulence arises in the upper generations of the airway. This turbulence appears only in the flow leaving the bifurcation, and at a point in the cycle centered around the maximum instantaneous flow rate. We hypothesize that its appearance is due to an instability of the longitudinal-vortices structure. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
34. Hazards to avoid in future neonatal studies of nasal high-frequency oscillatory ventilation: lessons from an early terminated trial
- Author
-
Hendrik S. Fischer, Christoph Bührer, and Christoph Czernik
- Subjects
Extubation ,High-frequency ventilation ,Hypercapnia ,Nasal continuous positive airway pressure ,Premature infant ,Randomised controlled trial ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objective To investigate whether nasal high-frequency oscillatory ventilation (nHFOV) started immediately after extubation of mechanically ventilated very low birth weight infants reduces the partial pressure of carbon dioxide at 72 h after extubation in comparison with nasal continuous positive airway pressure. This randomised controlled single-centre trial aimed to include 68 preterm infants at high risk of extubation failure. Results Implementation of the study protocol was feasible. However, from 2015 to 2017, only six patients could be recruited, leading to early termination of the trial. The slow recruitment was due to the introduction of new strategies to avoid endotracheal mechanical ventilation, which reduced the number of eligible infants. Moreover, the included infants failed their extubation more often than anticipated, thereby increasing the required sample size. Based on our single-centre experience, we provide information for study planning and discuss the specific requirements for future trial protocols on nHFOV. The extubation of high-risk infants into nHFOV could well be beneficial, but a multicentric approach is necessary to investigate this hypothesis. Trial Registration Clinicaltrials.gov NCT02340299, on 16 January 2015
- Published
- 2019
- Full Text
- View/download PDF
35. Intermittent High-Frequency Percussive Ventilation Therapy in 3 Patients with Severe COVID-19 Pneumonia.
- Author
-
Marchenko, Sergey P., Scarlatescu, Ecaterina, Vogt, Paul Robert, Naumov, Alexey, and Bognenko, Sergey
- Subjects
- *
HIGH-frequency ventilation (Therapy) , *COVID-19 , *COMPUTED tomography , *COVID-19 treatment , *PNEUMONIA , *VENTILATOR-associated pneumonia - Abstract
Objective: Unusual clinical course Background: High-frequency percussive ventilation (HFPV) is a method that combines mechanical ventilation with high-frequency oscillatory ventilation. This report describes 3 cases of patients with severe COVID-19 pneumonia who received intermittent adjunctive treatment with HFPV at a single center without requiring admission to the Intensive Care Unit (ICU). Cases Reports: Case 1 was a 60-year-old woman admitted to the hospital 14 days after the onset of SARS-CoV-2 infection symptoms, and cases 2 and 3 were men aged 65 and 72 years who were admitted to the hospital 10 days after the onset of SARS-CoV-2 infection symptoms. All 3 patients presented with clinical deterioration accompanied by worsening lung lesions on computed tomography (CT) scans after 21 days from the onset of symptoms. SARS-CoV-2 infection was confirmed in all patients by real-time reverse transcription-polymerase chain reaction (RT-PCR) assay from nasal swabs. All 3 patients had impending respiratory failure when non-invasive intermittent HFPV therapy was initiated. After therapy, the patients had significant clinical improvement and visibly decreased lung lesions on followup CT scans performed 4-6 days later. Conclusions: The 3 cases described in this report showed that the use of intermittent adjunctive treatment with HFPV in patients with severe pneumonia due to infection with SARS-CoV-2 improved lung function and may have prevented clinical deterioration. However, recommendations on the use of intermittent HFPV as an adjunctive treatment in COVID-19 pneumonia requires large-scale controlled clinical studies. In the pandemic context, with a shortage of ICU beds, avoiding ICU admission by using adjunctive therapies on the ward is a useful option. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
36. High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure.
- Author
-
Miller, Andrew G.
- Subjects
REACTIVE oxygen species ,ARTIFICIAL respiration ,CHI-squared test ,EXTRACORPOREAL membrane oxygenation ,INTENSIVE care units ,LONGITUDINAL method ,MEDICAL records ,NONPARAMETRIC statistics ,OXYGEN in the body ,PEDIATRICS ,REGRESSION analysis ,RESPIRATORY insufficiency ,SURVIVAL analysis (Biometry) ,T-test (Statistics) ,MATHEMATICAL variables ,STATISTICAL significance ,CONTINUING education units ,RETROSPECTIVE studies ,DATA analysis software ,DESCRIPTIVE statistics ,ACQUISITION of data methodology ,MANN Whitney U Test ,CHILDREN - Abstract
BACKGROUND: High-frequency jet ventilation (HFJV) is primarily used in premature neonates; however, its use in pediatric patients with acute respiratory failure has been reported. The objective of this study was to evaluate HFJV use in the pediatric critical care setting. We hypothesized that HFJV would be associated with improvements in oxygenation and ventilation. METHODS: Medical records of all patients who received HFJV in the pediatric ICU of a quaternary care center between 2014 and 2018 were retrospectively reviewed. Premature infants who had not been discharged home were excluded, as were those in whom HFJV was started while on extracorporeal membrane oxygenation. Data on demographics, pulmonary mechanics, gas exchange, and outcomes were extracted and analyzed using chi-square testing for categorical variables, nonparametric testing for continuous variables, and a linear effects model to evaluate gas exchange over time. RESULTS: A total of 35 subjects (median age = 2.9 months, median weight = 5.2 kg) were included. Prior to HFJV initiation, median (interquartile range) oxygenation index (OI) was 11.3 (7.2-16.9), PaO
2 /FIO2 = 133 (91.3-190.0), pH = 7.18 (7.11-7.27), PaO2 = 64 (52-87) mm Hg, and PaO2 = 74 (64-125) mm Hg. For subjects still on HFJV (n = 25), there was no significant change in OI, PaO2 /FIO2 , or PaO2 at 4-6 h after initiation, whereas pH increased (P = .001) and PaCO2 decreased (P = .001). For those remaining on HFJV for > 72 h (n = 12), the linear effects model revealed no differences over 72 h for OI, PaO2 /FIO2 , or mean airway pressure, but there was a decrease in FIO2 while pH and PaO2 increased. There were 9 (26%) subjects who did not survive, and nonsurvivors had higher Pediatric Index of Mortality 2 scores (P = .01), were more likely to be immunocompromised (P = .01), were less likely to have a documented infection (P = .02), and had lower airway resistance (P = .02). CONCLUSIONS: HFJV was associated with improved ventilation among subjects able to remain on HFJV but had no significant effect on oxygenation. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
37. Neonatal high frequency ventilation: Current trends and future directions.
- Author
-
Courtney SE, van Kaam AH, and Pillow JJ
- Subjects
- Infant, Newborn, Humans, Respiration, Artificial, Tidal Volume, High-Frequency Ventilation, Noninvasive Ventilation
- Abstract
High frequency ventilation (HFV) in neonates has been in use for over forty years. Some early HFV ventilators are no longer available, but high frequency oscillatory ventilation (HFOV) and jet ventilators (HFJV) continue to be commonly employed. Advanced HFOV models available outside of the United States are much quieter and easier to use, and are available as options on many conventional ventilators, providing important improvements such as tidal volume measurement and targeting. HFJV excels in treating air leak and non-homogenous lung disease and is often used for other diseases as well. High frequency non-invasive ventilation (hfNIV) is a novel application of HFV that remains under investigation. Similar to bubble CPAP, hfNIV has been applied with a variety of high-frequency ventilators. Efficacy and safety of hfNIV with any device have not yet been established. This article describes the current approaches to these HFV therapies and stresses the importance of understanding how each device works and what disease processes may respond best to the technology employed., Competing Interests: Declaration of competing interest The authors report no potential conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
38. Respiratory function testing for guiding ventilator mode conversion in congenital diaphragmatic hernia.
- Author
-
Kimura S, Toyoshima K, Shimokaze T, Katsumata K, Saito T, and Hoshino R
- Subjects
- Humans, Retrospective Studies, Respiration, Artificial, Ventilators, Mechanical, Hernias, Diaphragmatic, Congenital therapy, High-Frequency Ventilation, Cytomegalovirus Infections
- Abstract
Introduction: For patients with a congenital diaphragmatic hernia, conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV) are used in initial ventilatory management. HFOV has recently been recommended as a rescue therapy; however, we use HFOV for initial ventilation management, with a preoperative challenge test for CMV conversion and respiratory function testing at the time of CMV conversion. We aimed to compare patient characteristics between CMV conversion- and HFOV-preferred treatment groups., Methods: Ventilator settings and blood gases were retrospectively evaluated pre- and post-CMV conversion, and respiratory function tests for compliance of the respiratory system (Crs) and for resistance of the respiratory system (Rrs) were performed during the trial to CMV conversion., Results: No differences were observed between the CMV conversion- and HFOV-preferred groups regarding gestational age, birth weight, and observed/expected lung area-to-head circumference ratios. The median Crs (ml/cmH
2 O/kg) and Rrs (cmH2 O・kg/L/s) in the CMV conversion- and HFOV-preferred groups was 0.42 versus 0.53 (p = .44) and 467 versus 327 (p = .045), respectively. The pre and posttrial amount of change in blood gas levels and ventilator parameters in the CMV conversion- and HFOV-preferred groups were as follows: mean airway pressure, -2.0 versus 0 cmH2 O; partial pressure of carbon dioxide, 6.1 versus 2.9 Torr; alveolar-arterial oxygen difference, -39.5 versus -50 Torr; and oxygenation index, -1.0 versus -0.6; respectively., Conclusion: Respiratory function tests were useful in tailoring ventilator settings. Patients with high Rrs values responded better to CMV conversion., (© 2024 Wiley Periodicals LLC.)- Published
- 2024
- Full Text
- View/download PDF
39. EBNEO Commentary: Non-invasive high-frequency oscillatory ventilation vs nasal continuous positive airway pressure vs nasal intermittent positive pressure ventilation as postextubation support for preterm neonates in China: A randomized clinical trial.
- Author
-
Almudares F and Gandhi B
- Subjects
- Infant, Newborn, Humans, Intermittent Positive-Pressure Ventilation, Continuous Positive Airway Pressure, Infant, Premature, Nose, High-Frequency Ventilation, Respiratory Distress Syndrome, Newborn therapy, Noninvasive Ventilation
- Published
- 2024
- Full Text
- View/download PDF
40. Comparison of High-Frequency Oscillatory Ventilators.
- Author
-
Okazaki K and Kuroda J
- Subjects
- Humans, Lung, Ventilators, Mechanical, Tidal Volume, Pressure, High-Frequency Ventilation
- Abstract
Background: The performance of high-frequency oscillatory ventilators (HFOV) differs by the waveform generation mode and circuit characteristics. Few studies have described the performance of piston-type HFOV. The present study aimed to compare the amplitude required to reach the target high-frequency tidal volume ([Formula: see text]); determine the relationship between the settings and actual pressure in amplitude or mean airway pressure ([Formula: see text]); and describe the interaction among compliance, frequency, and endotracheal tube (ETT) inner diameter in 4 HFOV models, including Humming X, Vue (a piston type ventilator commonly used in Japan), VN500 (a diaphragm type), and SLE5000 (a reverse jet type)., Methods: The oscillatory ventilators were evaluated by using a 50-mL test lung with 0.5 and 1.0 mL/cm H
2 O compliance, [Formula: see text] of 10 cm H2 O, frequency of 12 and 15 Hz, and ETT inner diameters 2.0, 2.5, and 3.5 mm. At each permutation of compliance, frequency, and ETT, the target high-frequency [Formula: see text] was increased from 0.5 to 3.0 mL. The change in [Formula: see text] from the ventilator (ventilator [Formula: see text]) to Y-piece (Y [Formula: see text]) and alveolar pressure (alveolar [Formula: see text]) and the change in amplitude from the ventilator (ventilator amplitude) to Y-piece (Y amplitude) and alveolar pressure (alveolar amplitude) were determined at high-frequency [Formula: see text] of 1.0 and 3.0 mL., Results: To achieve the target high-frequency [Formula: see text], the Humming X and Vue required a higher amplitude than did the SLE5000, but the maximum amplitude in the VN500 was unable to attain a larger high-frequency [Formula: see text]. Ventilator [Formula: see text] and alveolar pressure decreased at the Y-piece with the Humming X and Vue but increased with the SLE5000. The ventilator [Formula: see text] in the VN500 decreased remarkably at a frequency of 15 Hz. The ventilator amplitude in all 4 ventilators decreased while temporarily increasing at the Y-piece in the VN500., Conclusions: The actual measured value, such as alveolar [Formula: see text] and high-frequency [Formula: see text], varied according to the type of HFOV system and the inner diameter of the ETT, even with identical settings. Clinicians should therefore determine the setting appropriate to each HFOV model., Competing Interests: The authors have disclosed no conflicts of interest., (Copyright © 2024 by Daedalus Enterprises.)- Published
- 2024
- Full Text
- View/download PDF
41. Volume Targeting During High-Frequency Oscillatory Ventilation: What Should Clinicians Know.
- Author
-
Tan HL, Lee JH, and Wong JJ
- Subjects
- Humans, Intermittent Positive-Pressure Ventilation, High-Frequency Ventilation
- Abstract
Competing Interests: The authors have disclosed no conflicts of interest.
- Published
- 2024
- Full Text
- View/download PDF
42. Use of Lung Ultrasound in Reducing Radiation Exposure in Neonates with Respiratory Distress: A Quality Management Project.
- Author
-
Nemes AF, Toma AI, Dima V, Serboiu SC, Necula AI, Stoiciu R, Ulmeanu AI, Marinescu A, and Ulmeanu C
- Subjects
- Infant, Newborn, Humans, Respiration, Artificial methods, Lung diagnostic imaging, High-Frequency Ventilation, Respiratory Distress Syndrome, Radiation Exposure prevention & control
- Abstract
Background and Objectives: Our quality management project aims to decrease by 20% the number of neonates with respiratory distress undergoing chest radiographs as part of their diagnosis and monitoring. Materials and Methods: This quality management project was developed at Life Memorial Hospital, Bucharest, between 2021 and 2023. Overall, 125 patients were included in the study. The project consisted of a training phase, then an implementation phase, and the final results were measured one year after the end of the implementation phase. The imaging protocol consisted of the performance of lung ultrasounds in all the patients on CPAP (continuous positive airway pressure) or mechanical ventilation (first ultrasound at about 90 min after delivery) and the performance of chest radiographs after endotracheal intubation in any case of deterioration of the status of the patient or if such a decision was taken by the clinician. The baseline characteristics of the population were noted and compared between years 2021, 2022, and 2023. The primary outcome measures were represented by the number of X-rays performed in ventilated patients per year (including the patients on CPAP, SIMV (synchronized intermittent mandatory ventilation), IPPV (intermittent positive pressure ventilation), HFOV (high-frequency oscillatory ventilation), the number of X-rays performed per patient on CPAP/year, the number of chest X-rays performed per mechanically ventilated patient/year and the mean radiation dose/patient/year. There was no randomization of the patients for the intervention. The results were compared between the year before the project was introduced and the 2 years across which the project was implemented. Results: The frequency of cases in which no chest X-ray was performed was significantly higher in 2023 compared to 2022 (58.1% vs. 35.8%; p = 0.03) or 2021 (58.1% vs. 34.5%; p = 0.05) (a decrease of 22.3% in 2023 compared with 2022 and of 23.6% in 2023 compared with 2021). The frequency of cases with one chest X-ray was significantly lower in 2023 compared to 2022 (16.3% vs. 35.8%; p = 0.032) or 2021 (16.3% vs. 44.8%; p = 0.008). The mean radiation dose decreased from 5.89 Gy × cm
2 in 2021 to 3.76 Gy × cm2 in 2023 (36% reduction). However, there was an increase in the number of ventilated patients with more than one X-ray (11 in 2023 versus 6 in 2021). We also noted a slight annual increase in the mean number of X-rays per patient receiving CPAP followed by mechanical ventilation (from 1.80 in 2021 to 2.33 in 2022 and then 2.50 in 2023), and there was a similar trend in the patients that received only mechanical ventilation without a statistically significant difference in these cases. Conclusions: The quality management project accomplished its goal by obtaining a statistically significant increase in the number of ventilated patients in which chest radiographs were not performed and also resulted in a more than 30% decrease in the radiation dose per ventilated patient. This task was accomplished mainly by increasing the number of patients on CPAP and the use only of lung ultrasound in the patients on CPAP and simple cases.- Published
- 2024
- Full Text
- View/download PDF
43. Evaluation of lung volumes and gas exchange in surfactant-deficient rabbits between variable and fixed servo pressures during high-frequency jet ventilation.
- Author
-
DiBlasi RM, Micheletti KJ, Romo T, Malone P, Orth J, Richards E, Kajimoto M, Goldstein JR, and Keszler M
- Subjects
- Animals, Humans, Rabbits, Surface-Active Agents, Lung, Lung Volume Measurements, Respiration, Artificial methods, High-Frequency Jet Ventilation, Pulmonary Surfactants, High-Frequency Ventilation
- Abstract
Objective: To investigate a novel servo pressure (SP) setting during high-frequency jet ventilation (HFJV) for a lung protective strategy in a neonatal model of acute respiratory distress., Study Design: Comparison of efficacy between variable (standard) and fixed SP settings in a randomized animal study using rabbits (n = 10, mean weight = 1.80 kg) with surfactant deficiency by repeated lung lavages., Results: Rabbits in the fixed SP group had greater peak inspiratory pressure, SP, minute volume, pH, and PaO
2 , and lower PaCO2 after lung lavage than the variable SP group. Lung volume monitoring with electrical impedance tomography showed that fixed SP reduced the decline of the global lung tidal variation at 30 min after lung lavage (-17.4% from baseline before lavage) compared to variable SP (-44.9%)., Conclusion: HFJV with fixed SP significantly improved gas exchange and lung volumes compared to variable SP. Applying a fixed SP may have important clinical implications for patients receiving HFJV., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)- Published
- 2024
- Full Text
- View/download PDF
44. Effect of a new respiratory care bundle on bronchopulmonary dysplasia in preterm neonates.
- Author
-
Ramos-Navarro, Cristina, González-Pacheco, Noelia, Rodríguez-Sánchez de la Blanca, Ana, and Sánchez-Luna, Manuel
- Subjects
- *
BRONCHOPULMONARY dysplasia , *PREMATURE infants , *NEWBORN infants , *ARTIFICIAL respiration , *RESPIRATORY therapists - Abstract
The development of devices that can fix the tidal volume in high-frequency oscillatory ventilation (HFOV) has allowed for a significant improvement in the management of HFOV. At our institution, this had led to the earlier use of HFOV and promoted a change in the treatment strategy involving the use of higher frequencies (above 15 Hz) and lower high-frequency tidal volumes (VThf). The purpose of this observational study was to assess how survival without bronchopulmonary dysplasia grades 2 and 3 (SF-BPD) is influenced by these modifications in the respiratory strategy applied to preterm infants (gestational age < 32 weeks at birth) who required mechanical ventilation (MV) in the first 3 days of life. We compared a baseline period (2012–2013) against a period in which this strategy had been fully implemented (2016–2017). A total of 182 patients were exposed to MV in the first 3 days of life being a higher proportion on HFOV at day 3 in the second period 79.5% (n 35) in 2016–2017 vs 55.4% (n 31) in 2012–2013. After adjusting for perinatal risk factors, the second period is associated with an increased rate of SF-BPD (OR 2.28; CI 95% 1.072–4.878); this effect is more evident in neonates born at a gestational age of less than 29 weeks (OR 4.87; 95% CI 1.9–12.48). Conclusions : The early use of HFOV combined with the use of higher frequencies and very low VT was associated with an increase in the study population's SF-BPD. What is Known: • High-frequency ventilation with volume guarantee improve ventilation stability and has been shown to reduce lung damage in animal models. What is New: • The strategy of an earlier use of high-frequency oscillatory ventilation combined with the use of higher frequencies and lower tidal volume is associated to an increase in survival without bronchopulmonary dysplasia in our population of preterm infants. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
45. Lung MRI assessment with high-frequency noninvasive ventilation at 3 T.
- Author
-
Darçot, Emeline, Delacoste, Jean, Dunet, Vincent, Dournes, Gael, Rotzinger, David, Bernasconi, Maurizio, Vremaroiu, Petrut, Simons, Julien, Long, Olivier, Rohner, Chantal, Ledoux, Jean-Baptiste, Stuber, Matthias, Lovis, Alban, and Beigelman-Aubry, Catherine
- Subjects
- *
NONINVASIVE ventilation , *LUNGS , *VISIBILITY , *VOLUNTEERS - Abstract
To investigate three MR pulse sequences under high-frequency noninvasive ventilation (HF-NIV) at 3 T and determine which one is better-suited to visualize the lung parenchyma. A 3D ultra-short echo time stack-of spirals Volumetric Interpolated Breath-hold Examination (UTE Spiral VIBE), without and with prospective gating, and a 3D double-echo UTE sequence with spiral phyllotaxis trajectory (3D radial UTE) were performed at 3 T in ten healthy volunteers under HF-NIV. Three experienced radiologists evaluated visibility and sharpness of normal anatomical structures, artifacts assessment, and signal and contrast ratio computation. The median of the three readers'scores was used for comparison, p <.05 was considered statistically significant. Incidental findings were recorded and reported. The 3D radial UTE resulted in less artifacts than the non-gated and gated UTE Spiral VIBE in inferior (score 3D radial UTE = 3, slight artifact without blurring vs. score UTE Spiral VIBE non-gated and gated = 2, moderate artifact with blurring of anatomical structure, p =.018 and p =.047, respectively) and superior lung regions (score 3D radial UTE = 3, vs. score UTE Spiral VIBE non-gated = 2.5, p =.48 and score UTE Spiral VIBE gated = 1, severe artifact with no normal structure recognizable, p =.014), and higher signal and contrast ratios (p =.002, p =.093). UTE Spiral VIBE sequences provided higher peripheral vasculature visibility than the 3D radial UTE (94.4% vs 80.6%, respectively, p <.001). The HF-NIV was well tolerated by healthy volunteers who reported on average minor discomfort. In three volunteers, 12 of 18 nodules confirmed with low-dose CT were identified with MRI (average size 2.6 ± 1.2 mm). The 3D radial UTE provided higher image quality than the UTE Spiral VIBE. Nevertheless, a better nodule assessment was noticed with the UTE Spiral VIBE that might be due to better peripheral vasculature visibility, and requires confirmation in a larger cohort. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
46. Mortality Risk Factors in Preterm Infants Treated with High-Frequency Jet Ventilation.
- Author
-
Wheeler, Craig R., Stephens, Holly, O'Donnell, Iris, Zurakowski, David, and Smallwood, Craig D.
- Subjects
ARTIFICIAL respiration ,BIRTH weight ,BRONCHOPULMONARY dysplasia ,CHI-squared test ,CONFIDENCE intervals ,CONFERENCES & conventions ,FISHER exact test ,GESTATIONAL age ,INFANT mortality ,OXYGEN in the body ,RESPIRATION ,RISK assessment ,SEX distribution ,STATISTICAL hypothesis testing ,MULTIPLE regression analysis ,CONTINUING education units ,RETROSPECTIVE studies ,RECEIVER operating characteristic curves ,DATA analysis software ,STATISTICAL models ,ODDS ratio ,MANN Whitney U Test - Abstract
BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for premature infants with respiratory failure. We sought to identify parameters that were associated with mortality in subjects who underwent HFJV. METHODS: Subjects were enrolled if birthweight was ≤ 2,000 g and they were ≤ 34 weeks gestational age. Subjects were excluded if they received HFJV at the time of admission because we aimed to study subjects who failed conventional ventilation. Subject demographics, ventilator parameters, and laboratory data were extracted and analyzed. The Mann-Whitney U-test was used to assess differences in continuous variables, and the chi-square and Fisher exact tests were used for categorical variables between the groups. To assess variables that were predictive of mortality, we used both univariate and multivariate logistic regression analysis. Independent predictors of mortality were identified and used to create a multivariate risk score. Receiver operating characteristic curves were constructed to evaluate the predictive accuracy of the multivariate risk score. RESULTS: A total of 53 premature subjects (n = 37 male) were studied, of whom 39 (74%) survived to discharge or transfer back to referring hospital. In the univariate model, female sex, older gestational age, higher birthweight, HFJV peak inspiratory pressure at 1 h, and oxygen saturation index at 4 h were associated with mortality. In the final multivariate logistic regression model, female sex (odds ratio 4.1, 95% CI 1.2-19.8, P = .044), closed ductus arteriosus (odds ratio 7.7, 95% CI 1.3-39.5, P = .016), and oxygen saturation index > 5.5 (odds ratio 6.0, 95% CI 1.5-28.3, P = .02) were independent predictors of mortality. CONCLUSIONS: We identified that oxygen saturation index > 5.5 after 4 h of HFJV, female sex, and closed ductus arteriosus were independent predictors of mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
47. High-Frequency Oscillatory Ventilation in Pediatric Acute Hypoxemic Respiratory Failure: Disease-Specific Morbidity Survival Analysis
- Author
-
Babbitt, Christopher J, Cooper, Michael C, Nussbaum, Eliezer, Liao, Eileen, Levine, Glenn K, and Randhawa, Inderpal S
- Subjects
Paediatrics ,Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Trials and Supportive Activities ,Pediatric ,Lung ,Infectious Diseases ,Patient Safety ,Clinical Research ,Respiratory ,Good Health and Well Being ,Disease-Free Survival ,Female ,High-Frequency Ventilation ,Humans ,Hypoxia ,Infant ,Male ,Oxygen ,Respiratory Insufficiency ,Acute hypoxemic respiratory failure ,Acute respiratory distress syndrome ,High-frequency oscillatory ventilation ,Sepsis ,Cardiorespiratory Medicine and Haematology ,Respiratory System ,Cardiovascular medicine and haematology - Abstract
BackgroundMultiple ventilatory strategies for acute hypoxemic respiratory failure (AHRF) in children have been advocated, including high-frequency oscillatory ventilation (HFOV). Despite the frequent deployment of HFOV, randomized controlled trials remain elusive and currently there are no pediatric trials looking at its use. Our longitudinal study analyzed the predictive clinical outcome of HFOV in pediatric AHRF given disease-specific morbidity.MethodsA retrospective 8-year review on pediatric intensive care unit admissions with AHRF ventilated by HFOV was performed. Primary outcomes included survival, morbidity, length of stay (LOS), and factors associated with survival or mortality.ResultsA total of 102 patients underwent HFOV with a 66 % overall survival rate. Survivors had a greater LOS than nonsurvivors (p = 0.001). Mortality odds ratio (OR) for patients without bronchiolitis was 8.19 (CI = 1.02, 65.43), and without pneumonia it was 3.07 (CI = 1.12, 8.39). A lower oxygenation index (OI) after HFOV commencement and at subsequent time points analyzed predicted survival. After 24 h, mortality was associated with an OI > 35 [OR = 31.11 (CI = 3.25, 297.98)]. Sepsis-related mortality was associated with a higher baseline FiO(2) (0.88 vs. 0.65), higher OI (42 vs. 22), and augmented metabolic acidosis (pH of 7.25 vs. 7.32) evaluated 4 h on HFOV (p < 0.05).ConclusionHigh-frequency oscillatory ventilation may be safely utilized. It has a 66 % overall survival rate in pediatric AHRF of various etiologies. Patients with morbidity limited to the respiratory system and optimized oxygenation indices are most likely to survive on HFOV.
- Published
- 2012
48. Effect of High-Frequency Oscillatory Ventilation, Combined With Prone Positioning, in Infants With Acute Respiratory Distress Syndrome After Congenital Heart Surgery: A Prospective Randomized Controlled Trial
- Author
-
Yi-Rong Zheng, Yu-Kun Chen, Shi-Hao Lin, Hua Cao, and Qiang Chen
- Subjects
Heart Defects, Congenital ,Respiratory Distress Syndrome ,Anesthesiology and Pain Medicine ,Prone Position ,High-Frequency Ventilation ,Humans ,Infant ,Prospective Studies ,Cardiology and Cardiovascular Medicine - Abstract
This study aimed to evaluate the effect of high-frequency oscillatory ventilation, (HFOV) combined with prone positioning, on oxygenation and pulmonary ventilation in infants with acute respiratory distress syndrome (ARDS) after congenital heart surgery.A randomized controlled trial.A single-center study at a tertiary teaching hospital.Patients with postoperative ARDS after congenital heart disease were divided randomly into the following 2 groups: HFOV combined with prone position (HFOV-PP), and HFOV combined with supine position (HFOV-SP).The primary outcomes were the PaOSixty-five eligible infants with ARDS were randomized to either the HFOV-PP (n = 32) or HFOV-SP (n = 33) group. No significant difference in baseline data was found between the 2 groups (p0.05). Oxygenation was improved in both groups after HFOV intervention. Compared with the HFOV-SP group, the HFOV-PP group had significantly increased PaOHFOV-PP significantly improved oxygenation in infants with ARDS after cardiac surgery and had no serious complications.
- Published
- 2022
49. MANAGEMENT OF ACUTE RESPIRATORY DISTRESS SYNDROME IN A CHILD WITH ADENOVIRUS PNEUMONIA: CASE REPORT AND LITERATURE REVIEW
- Author
-
Felipe Rezende Caino de Oliveira, Krisna de Medeiros Macias, Patricia Andrea Rolli, José Colleti Junior, and Werther Brunow de Carvalho
- Subjects
High-frequency ventilation ,Pneumonia ,Respiratory Distress Syndrome, adult ,Adenoviruses, human ,Pediatrics ,RJ1-570 - Abstract
ABSTRACT Objective: To report the case of a child who developed acute respiratory distress syndrome (ARDS) from a pulmonary infection by adenovirus. Case description: A female patient aged 2 years and 6 months, weighting 10,295 grams developed fever, productive cough and vomiting, later on progressing to ARDS despite initial therapy in accordance with the institutional protocol for ARDS treatment. The child evolved to refractory hypoxemia and hypercapnia, requiring high parameters of mechanical pulmonary ventilation and use of vasoactive agents. In the treatment escalation, the patient received steroids, inhaled nitric oxide (iNO), was submitted to the prone position, started oscillatory high-frequency ventilation (HFOV) and extracorporeal membrane oxygenation (ECMO) was indicated due to severe refractory hypoxemia. During this time, the patient’s clinical response was favorable to HFOV, improving oxygenation index and hypercapnia, allowing the reduction of vasoactive medications and mechanical ventilation parameters, and then the indication of ECMO was suspended. The patient was discharged after 26 days of hospital stay without respiratory or neurological sequelae. Comments: Adenovirus infections occur mainly in infants and children under 5 years of age and represent 2 to 5% of respiratory diseases among pediatric patients. Although most children with adenovirus develop a mild upper respiratory tract disease, more severe cases can occur. ARDS is a serious pulmonary inflammatory process with alveolar damage and hypoxemic respiratory failure; Adenovirus pneumonia in children may manifest as severe pulmonary morbidity and respiratory failure that may require prolonged mechanical ventilation. Exclusive pulmonary recruitment and HFOV are advantageous therapeutic options.
- Published
- 2020
- Full Text
- View/download PDF
50. 'Low-' versus 'high'-frequency oscillation and right ventricular function in ARDS. A randomized crossover study
- Author
-
Spyros D. Mentzelopoulos, Hector Anninos, Sotirios Malachias, and Spyros G. Zakynthinos
- Subjects
High-frequency ventilation ,Respiratory distress syndrome ,Adult ,Heart ventricles ,Hypercapnia ,Echocardiography ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Recent, large trials of high-frequency oscillation (HFO) versus conventional ventilation (CV) in acute respiratory distress syndrome (ARDS) reported negative results. This could be explained by an HFO-induced right ventricular (RV) dysfunction/failure due to high intrathoracic pressures and hypercapnia. We hypothesized that HFO strategies aimed at averting/attenuating hypercapnia, such as “low-frequency” (i.e., 4 Hz) HFO and 4-Hz HFO with tracheal-gas insufflation (HFO-TGI), may result in an improved RV function relative to “high-frequency” (i.e., 7 Hz) HFO (which may promote hypercapnia) and similar RV function relative to lung protective CV. Methods We studied 17 patients with moderate-to-severe ARDS [PaO2-to-inspiratory O2 fraction ratio (PaO2/FiO2)
- Published
- 2018
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.