High-frequency Oscillatory Ventilation in Children: A 10-year Experience

Moniz, Marta; Silvestre, Catarina; Nunes, Pedro; Abadesso, Clara; Matias, Ester; Loureiro, Helena; Almeida, Helena

doi:10.1016/j.jped.2013.02.008

Cited by 18 publications

(13 citation statements)

References 21 publications

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“…As regards oxygenation improvement, we found that HFO significantly improved oxygenation after 24 hours of enrollment, a finding that is comparable with results in several pediatric studies 35,[45][46][47] and adult studies 34,36 . Also survivors among HFO group showed significant higher OI decrease percent, PaO 2 /FiO 2 after 24 hours and higher PaO 2 /FiO 2 increase percent.…”

Section: Volume 59 • Number 2 Hfo Versus CMV In Pediatric Ardssupporting

confidence: 90%

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

et al. 2017

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Although the HFO mode appeared to be a safe mode with a significant better oxygenation improvement (after the first 24 hours) and fewer crossover rates, it failed to show differences as regards mortality or LOS when compared to the CMV adopting protective lung strategy. In PARDS, HFO had a superior advantage in improving oxygenation, yet with no significant mortality improvement, as multi-organ dysfunction syndrome (MODS) was the most common cause of death in our study and not refractory hypoxemia which is the main problem in PARDS; highlighting that mortality in PARDS is multi-factorial and may not depend only on how fast oxygenation improves.

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Section: Volume 59 • Number 2 Hfo Versus CMV In Pediatric Ardssupporting

confidence: 90%

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

et al. 2017

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“…Evidence for the use of HFOV remains weak in paediatric acute respiratory distress syndrome (PARDS). Majority of studies conducted thus far are small [10][11][12][13][14][15][16][17]. Similar to studies performed in other populations, paediatric studies of HFOV showed a benefit in short-term oxygenation without any improvement in clinical outcomes [12,18,19].…”

Section: Introductionmentioning

confidence: 60%

“…Majority of studies conducted thus far are small [10][11][12][13][14][15][16][17]. Similar to studies performed in other populations, paediatric studies of HFOV showed a benefit in short-term oxygenation without any improvement in clinical outcomes [12,18,19]. HFOV use in children with acute respiratory failure was associated with increased mortality, duration of MV and paediatric intensive care unit (PICU) stay compared to those who were not supported with HFOV [20,21].…”

Section: Introductionmentioning

confidence: 76%

The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome

et al. 2020

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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 < 0.001). A total of 118 pairs were matched in the GM method which found a significant association between HFOV with 28-day mortality in PARDS [odds ratio 2.3, 95% confidence interval (CI) 1.3, 4.4, p value 0.01]. VFD was indifferent between the HFOV and non-HFOV group [mean difference − 1.3 (95%CI − 3.4, 0.9); p = 0.29] but IFD was significantly lower in the HFOV group [− 2.5 (95%CI − 4.9, − 0.5); p = 0.03]. From the sensitivity analysis, PS matching, IPTW and MSM all showed consistent direction of HFOV treatment effect in PARDS.

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“…Given the predisposition to hypoventilation and the risk of acute pulmonary edema, the mechanical ventilation of patients intoxicated with salicylates requires a lot of attention [18,19]. Highfrequency ventilation and ECMO should be considered to treat some severe intoxications, but there are limited reports on their use in pediatric toxicology [4,20].…”

Section: The Poisoning Effects On Specific Organ Systems 41 Acute Rementioning

confidence: 99%

Poisoning in the Pediatric Intensive Care Unit

Nistor¹,

Frăsinariu²,

Rugină³

et al. 2019

Poisoning in the Modern World - New Tricks for an Old Dog?

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Poisonings during childhood (both accidental and voluntary) are a common cause of presentation in the emergency departments (EDs) and the pediatric intensive care unit (PICU). The admission to PICU is warranted both for treatment and for continuous monitoring, as sometimes the evolution of a poisoning could be unpredictable. Sometimes, complications arise that may prolong the patients' hospitalization and may contribute to lowering the survival rate. The staff in these departments must be well trained to ensure patient monitoring, early detection of complications, and rapid intervention. Supporting vital functions is the main objective of the management of a poisoned patient admitted in PICU. In recent years, staff competence and advanced medical technology have helped to improve the prognosis of the patients admitted to these departments, including of the poisoned patients.

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High-frequency Oscillatory Ventilation in Children: A 10-year Experience

Abstract: HFOV enabled an improvement in hypercapnia and oxygenation. It is a safe option for the treatment of ARDS and severe small airway diseases.

Cited by 18 publications

References 21 publications

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

The impact of high frequency oscillatory ventilation on mortality in paediatric acute respiratory distress syndrome

Poisoning in the Pediatric Intensive Care Unit

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