Nasal high‐frequency ventilation for premature infants

Colaizy, Tarah T.; Younis, Usama M M; Bell, Edward F.; Klein, Jonathan M.

doi:10.1111/j.1651-2227.2008.00900.x

Cited by 83 publications

(84 citation statements)

References 18 publications

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“…It has all the benefits of NIPPV with the added advantage of not being as dependent on breath synchronization, something that can presently be difficult to achieve with NIPPV [9]. Limited studies on the clinical use of nHFO in neonates are available, [11,12,13] and the existing data do not adequately address CO 2 elimination efficacy. All available clinical studies of nHFO have reported on blood PCO 2 comparative changes pre and post initiation of this treatment modality [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Its use also does not require synchronization of breaths as the patient can comfortably continue normal tidal breathing while on the ventilator and thus has the potential to provide superior noninvasive ventilation. Only a limited number of clinical studies have explored the use of noninvasive high-frequency ventilation but whether this strategy is able to support adequate gas exchange in neonates has not been thoroughly addressed [11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

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Nasal High-Frequency Oscillation for Lung Carbon Dioxide Clearance in the Newborn

Mukerji

Finelli²,

Belik³

2012

Neonatology

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Background: Noninvasive ventilation has been used increasingly in recent years to minimize the duration of endotracheal mechanical ventilation in neonates due to its association with lung injury. Nasal high-frequency oscillation (nHFO) is a relatively new noninvasive modality but evidence for its use is limited. Objective: The goal of this study was to compare the CO₂ clearance efficacy of nHFO and noninvasive positive pressure ventilation (NIPPV) in a neonatal lung model. Design/Methods: A newborn mannequin with dimensions and anatomy similar to a term infant was utilized. It was connected to a commercially available neonatal mechanical ventilator using a manufacturer-provided nasal adaptor. Various modes of noninvasive ventilation were compared as CO₂ clearance was measured at the oropharynx by an end-tidal CO₂ analyzer following the addition of a known amount of CO₂ into the lung. Measurements were obtained at two different lung compliances using nHFO and compared with nCMV and nasal continuous positive airway pressure (nCPAP) as a control. Pressures near the nasal adaptor and the larynx were simultaneously measured with in-line pressure transducers. Results: Whereas no CO₂ elimination was observed under nCPAP, its clearance with nHFO was 3-fold greater as compared to NIPPV. On nHFO, CO₂ clearance was inversely proportional to frequency and maximal at 6 and 8 Hz. At a lower lung compliance, CO₂ clearance was significantly higher at 6 Hz as compared to 10 Hz. During nHFO set to deliver a MAP of 10.0, we documented pressures of 7.2 ± 0.3 at the nasal adaptor and only 2.3 ± 0.3 cm H₂O at the larynx. Conclusions: Nasal HFO is effective and superior to NIPPV at lung CO₂ elimination in a newborn mannequin model. The use of nHFO as the preferred mode of noninvasive ventilation warrants further clinical studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nasal High-Frequency Oscillation for Lung Carbon Dioxide Clearance in the Newborn

Mukerji

Finelli²,

Belik³

2012

Neonatology

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“…Short-term observational studies have suggested initial mean airway pressure set to equal the previous CPAP, frequency set at 10 Hz, amplitude adjusted to obtain visible chest-wall vibration and increased every 30 min by 4 -6 units, if necessary, to maintain clinically appropriate chest-wall vibration, transcutaneous CO 2 , or blood gas values. 80,81 Clinical responses to HFV in preterm neonates in 2 small studies have been reported. Van der Hoeven et al 79 placed 21 preterm and term infants with moderate respiratory insufficiency on nasal HFV following CPAP.…”

Section: Nasal High-frequency Ventilationmentioning

confidence: 99%

Neonatal Noninvasive Ventilation Techniques: Do We Really Need to Intubate?

DiBlasi

2011

Respir Care

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“…72 A small interventional study in 14 very low birth weight infants on nCPAP revealed similar benefits when PCO 2 was measured before and after 2 hours of nHFOV. 73 Other observational studies revealed successful use of nHFOV as rescue therapy for nCPAP failure 74 and in the postextubation period. 75 To explore the future role that nHFOV could play in the treatment of RDS, further research on effectiveness and safety is needed.…”

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confidence: 99%

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

2013

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Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis abstract BACKGROUND AND OBJECTIVE: Mechanical ventilation via an endotra-cheal tube is a risk factor for bronchopulmonary dysplasia (BPD), one of the most common morbidities of very preterm infants. Our objective was to investigate the effect that strategies to avoid endotracheal mechanical ventilation (eMV) have on the incidence of BPD in preterm infants ,30 weeks' gestational age (GA). METHODS: In February 2013, we searched the databases Medline, Embase, and the Cochrane Central Register of Controlled Trials. Study selection criteria included randomized controlled trials published in peer-reviewed journals since the year 2000 that compared preterm infants ,30 weeks' GA treated by using a strategy aimed at avoiding eMV with a control group in which mechanical ventilation via an endotracheal tube was performed at an earlier stage. Data were extracted and analyzed by using the standard methods of the Cochrane Neonatal Review Group. The authors independently assessed study eligibility and risk of bias, extracted data and calculated odds ratios and 95% confidence intervals, employing RevMan version 5.1.6. RESULTS: We identified 7 trials that included a total of 3289 infants. The combined odds ratio (95% confidence interval) of death or BPD was 0.83 (0.71-0.96). The number needed to treat was 35. The study results were remarkably homogeneous. Avoiding eMV had no influence on the incidence of severe intraventricular hemorrhage.

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Nasal high‐frequency ventilation for premature infants

Abstract: Nasal HFV is effective in decreasing pCO(2) in stable premature infants requiring nasal CPAP support. Long-term use of nasal HFV requires further study.

Cited by 83 publications

References 18 publications

Nasal High-Frequency Oscillation for Lung Carbon Dioxide Clearance in the Newborn

Nasal High-Frequency Oscillation for Lung Carbon Dioxide Clearance in the Newborn

Neonatal Noninvasive Ventilation Techniques: Do We Really Need to Intubate?

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

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