Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants

Dj, Henderson-Smart; Bhuta, Tushar; Cools, Filip; Offringa, Martin

doi:10.1002/14651858.cd000104

Cited by 71 publications

(56 citation statements)

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“…1 This is consistent with meta-analyses demonstrating that although there is no convincing benefit to elective high frequency ventilation, 17,18 there may possibly be some benefit with high frequency ventilation used for 'rescue' of infants with hypoxemic respiratory failure. 19,20 In summary, stepwise regression and CART models identified variables and the optimal cut points of the variables that are associated with death and/or physiologic BPD in premature infants with severe respiratory failure.…”

Section: Discussionmentioning

confidence: 54%

Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

et al. 2008

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Objectives: To identify the variables that predict death/physiologic bronchopulmonary dysplasia (BPD) in preterm infants with severe respiratory failure.Study Design: The study was a secondary analysis of data from the NICHD Neonatal Research Network trial of inhaled nitric oxide (iNO) in preterm infants. Stepwise logistic regression models and Classification and Regression Tree (CART) models were developed for the outcome of death or physiologic BPD (O 2 at 36 weeks post-menstrual age).Result: Death and/or BPD was associated with lower birth weight, higher oxygen requirement, male gender, additional surfactant doses, higher oxygenation index and outborn status, but not the magnitude of response in PaO 2 to iNO. The positive predictive value of the CART model was 82% at 95% sensitivity. Conclusions:The major factors associated with death/BPD were an increased severity of respiratory failure, lower birth weight, male gender and outborn status, but not the magnitude of initial response to iNO.

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Section: Discussionmentioning

confidence: 54%

Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

et al. 2008

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“…Therefore, one might expect that with HFOV important goals of lung protective ventilation (preventing physical injury due to repetitive closure and re-opening of alveoli) may be achieved. Most of the clinical HFOV studies were conducted in newborns with neonatal RDS; however, no clear benefit on mortality compared with conventional ventilation (CV) was observed [95][96][97][98][99].…”

Section: High-frequency Oscillatory Ventilationmentioning

confidence: 99%

Pediatric acute lung injury

Dahlem

Aalderen

Bos

2007

Paediatric Respiratory Reviews

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“…Porém, nas últimas 2 décadas, vários estudos clínicos têm sido realizados, e os resultados continuam controversos [57][58][59][60][61][62][63][64][65] . Duas revisões feitas pela Cochrane Database não evidenciaram grandes vantagens do uso da ventilação de alta freqüência.…”

Section: Ventilação De Alta Freqüênciaunclassified

“…Duas revisões feitas pela Cochrane Database não evidenciaram grandes vantagens do uso da ventilação de alta freqüência. Alguns dos estudos incluídos mostraram uma discreta diminuição da incidência de DBP, enquanto que, em outros, houve um significante aumento da hemorragia intraventicular e da síndrome de extravasamento de ar 64,65 . Ao comparar a OAF com a ventilação mecânica convencional em recém-nascidos prematuros, os autores concluíram que a OAF não leva à redução da DBP ou da mortalidade, comparada à ventilação mecânica convencional, quando usada como tratamento inicial na SDR do prematuro extremo 64 .…”

Section: Ventilação De Alta Freqüênciaunclassified

Strategies to minimize lung injury in extremely low birth weight infants

Suguihara¹,

Lessa²

2005

J Pediatr (Rio J)

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Como citar este artigo: Suguihara C, Lessa AC. Como minimizar a lesão pulmonar no prematuro extremo: propostas. J Pediatr (Rio J). 2005;81(1 Supl):S69-S78. AbstractObjective: To review the main causes of new bronchopulmonary dysplasia and the strategies utilized to decrease its incidence in extremely low birth weight infants. Sources of data:For this review a MEDLINE search from 1966 to October 2004, the Cochrane Database, abstracts from the Society for Pediatric Research and recent meetings on the topic were used. Summary of the findings:The survival of extremely low birth weight infants has increased significantly due to improvement in both scientific knowledge and technology. This improvement in survival has therefore resulted in an increased incidence of bronchopulmonary dysplasia. The characteristics of bronchopulmonary dysplasia in extremely low birth weight infants, the so called new bronchopulmonary dysplasia are quite different from the classic bronchopulmonary dysplasia described by Northway. This new bronchopulmonary dysplasia has a multifactorial etiology, which includes volutrauma, atelectrauma, oxygen toxicity and lung inflammation. Therapy such as prenatal corticosteroids, exogenous surfactant, nasal continuous positive airway pressure, new mechanical ventilation modalities and gentle ventilation have been used in attempts to decrease lung injury severity. Conclusions:In order to prevent lung injury in extremely low birth weight infants, it is necessary to minimize several factors that induce bronchopulmonary dysplasia and to utilize less aggressive therapeutic strategies. In addition to the current therapy used to decrease lung injury, knowledge of these causative factors may create new therapies that may be fundamental in improving the clinical outcomes of premature infants.J Pediatr (Rio J). 2005;81(1 Supl):S69-S78: Extremely low birth weight infant, bronchopulmonary dysplasia, mechanical ventilation. ResumoObjetivo: Apresentar uma revisão das principais causas da nova displasia broncopulmonar e as estratégias utilizadas para diminuir sua incidência nos prematuros extremos. Fontes dos dados:Para essa revisão, pesquisas foram feitas na MEDLINE (1996 a outubro de 2004), no Cochrane Database, em resumos da Society for Pediatric Research e recentes conferências sobre o tema. Síntese dos dados:A tecnologia e os novos conhecimentos científicos têm aumentado significantemente a sobrevida de prematuros extremos. Esse aumento da sobrevida resultou em aumento da incidência de displasia broncopulmonar. Atualmente, a displasia broncopulmonar é mais freqüentemente observada em recém-nascidos < 1.200 g. As características da displasia broncopulmonar nesses prematuros extremos, atualmente chamada de nova displasia broncopulmonar, são bastante diferentes da clássica descrita por Northway. A nova displasia broncopulmonar tem etiologia multifatorial, como volutrauma, atelectrauma, toxicidade ao oxigênio e reação inflamatória. Terapias como corticosteróide pré-natal, surfactante exógeno, pressão aérea positiva co...

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Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants

Cited by 71 publications

References 0 publications

Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

Pediatric acute lung injury

Strategies to minimize lung injury in extremely low birth weight infants

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