All issues > Volume 41(4); 1998

Original Article

J Korean Pediatr Soc. 1998;41(4):456-465. Published online April 15, 1998.

High Frequency Oscillatory Ventilation as a Rescue Therapy of Severe Neonatal Respiratory Failure

Eun Kyung EK Lee¹, Yun Sil YS Chang¹, Won Soon WS Park¹

¹Department of pediatrics, College of Medicine, Sung Kyun Kwan University, Samsung Medical Centerm Seoul, Korea

Correspondence Eun Kyung EK Lee ,Tel: +82.2-3468-3107, Fax: +82.2-558-1119, 

Abstract

Purpose
: High frequency oscillatory ventilation(HFOV) using suprathysiologic ventilatory frequency is a new therapeutic technique, which has a improved survival and reduced complication of newborn infants suffering from severe respiratory failure. The aim of this study was to assess the efficacy of HFOV as a rescue therapy for infants with severe respiratory failure and to compare the treatment results of several types of respiratory diseases.
Methods
: Retrospective analysis of the medical records of neonates who were admitted due to severe respiratory failure, they had an arterio-alveolar oxygen tension ratio below 0.25 despite of conventional mechanical venrilation.
Results
: twenty-two neonates(survivor group 15, nonsurvivor group 7) were evaluated. HFOV treatment was initianted at 4.0¡¾4.6 days after birth in survivor group, and 4.4¡¾3.1 days in nonsurvivor group. Plmonary hemorrhage and airleak syndrome is the most common indication of HFOV. The highest survival rate was 75.0% in homogenous lung diseases. The oxygenation index after 12 hours and a/APO2 after 6 hours on HFOV were significantly higher in those infants who survived, compared to those who died(P<0.05). The complications after HFOV were pneumothorax(survivor group 1, nonsurvivor group 3) and bronchopulmonary dyslasia(survivr group 5 nonsurvivor group 2).
Conclusion
: We concluded that high frequency oscillatiory ventilation significantly improves oxygenation in neonates with severe pulmonary disease, who did not respond to conventional mechanical cenrilator therapy, and is useful as a rescue therapy in severe neonetal respiratory failure.

Keywords :High frequency oscillatory ventilation, Neomate, Respiratory failure