Rescue high frequency ventilation for congenital diaphragmatic hernia

Autor:	Ronald E. Dechert, Steven M. Donn, Mohammad A. Attar
Rok vydání:	2019
Předmět:	Male medicine.medical_treatment Partial Pressure Hemodynamics High-Frequency Ventilation Mean airway pressure High-Frequency Jet Ventilation 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation 030225 pediatrics Pressure Medicine Humans Herniorrhaphy Retrospective Studies Mechanical ventilation 030219 obstetrics & reproductive medicine business.industry Pulmonary Gas Exchange High-frequency ventilation Infant Newborn Congenital diaphragmatic hernia medicine.disease Respiration Artificial Respiratory failure Anesthesia Pediatrics Perinatology and Child Health Breathing Arterial blood Female Blood Gas Analysis business Hernias Diaphragmatic Congenital Respiratory Insufficiency
Zdroj:	Journal of neonatal-perinatal medicine. 12(2)
ISSN:	1878-4429
Popis:	Introduction High frequency jet (HFJV) and oscillatory (HFOV) ventilation were used to rescue newborns with congenital diaphragmatic hernia (CDH), who failed conventional mechanical ventilation (CV). Changes in ventilator settings and pulmonary gas exchange were evaluated following transition to high frequency ventilation (HFV). Methods Records of patients with CDH rescued with HFV prior to surgical intervention between 2006 and 2015 were reviewed. Mean airway pressure (Pāw) and arterial blood gases during CV and those obtained within the first hour of HFV were compared. A composite repeated measure analysis was performed to evaluate longitudinal and intergroup variances. Results Twenty-seven patients were rescued from CV, 16 by HFJV and 11 by HFOV. The two groups had similar gestational ages and birth weights. Prior to HFV, both groups had similar Pāw, PaCO2, FiO2 and PaO2. HFV was associated with a significant improvement in ventilation, and the rate of decrease of PaCO2 was no different between groups. There was a significantly higher increase in Pāw increase with HFOV compared to HFJV. Conclusions In newborns with CDH rescued with HFV, ventilation improved but Pāw was significantly lower in patients supported with HFJV compared to HFOV.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::09fc7f96f5b915cbf845a86ffad71013 https://pubmed.ncbi.nlm.nih.gov/30829621 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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