PubMed · 2037436
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W A Hodson. 1991. High-frequency oscillatory ventilation.. https://doi.org/10.1017/s0266462300012484
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We successfully used high-frequency oscillatory ventilation (HFOV) for treating severe acquired lobar emphysema in two premature newborn infants (birth weights, 1,450 and 1,300 g). After successful weaning from mechanical ventilation for hyaline membrane disease, they needed additional ventilatory support because they developed severe lobar emphysema compressing the residual lung. In both patients, radiographic signs of lobar emphysema disappeared completely after 3 days of HFOV. Diagnosis and follow-up were confirmed by high-resolution computed tomography. We conclude that HFOV may be a useful noninvasive method for treating severe lobar emphysema.
OBJECTIVE: To report ventilation strategies, survival and complications in 39 outborn infants treated with high frequency oscillatory ventilation (HFOV). METHODOLOGY: Data were collected prospectively between 1 May 1992 and 31 December 1993 on all infants treated with HFOV who had severe respiratory failure despite optimal conventional ventilation. RESULTS: Twenty-eight out of 39 (72%) survived. Of the 15 infants with birthweights < 1500 g, eight survived. Best survival rates were for infants with pulmonary interstitial emphysema with air leak (4/5) and for infants of birthweight > 1500 g with hyaline membrane disease (8/8), and meconium aspiration syndrome (7/7). Three infants deteriorated while on HFOV and required extracorporeal membrane oxygenation. Complications were: (i) development of pulmonary interstitial emphysema (1); (ii) recurrence of pneumothorax (3); (iii) hypotension (2); and (iv) bronchopulmonary dysplasia (9). One of the eight infants weighing < 1500 g who received HFOV in the first week of life developed periventricular haemorrhage. CONCLUSION: The initial results of HFOV for severe failure were encouraging although a learning curve was encountered with its introduction.