- 期刊
High-Frequency Oscillatory Ventilation in Neonates with Acute Pulmonary Dysfunction
並列摘要
Acute pulmonary dysfunction with respiratory failure is a major cause of mortality in critical neonates. Although there has been much advancement in neonatal respiratory care, chronic lung disease is still a serious problem. High-frequency-oscillatory ventilation (HFOV) has been shown to be a promising technique in reducing ventilator-induced lung injury in many animal studies. It needs a rapid oscillatory rate at 4 to 15 Hz, and a continuous bias flow to maintain mean airway pressure (MAP) which helps recruitment of diseased lungs. Its delivered tidal volume is less than dead space (1-3 mL/kg), and the volume delivery needs a piston pump or an electromagnetic flow generator. In adjusting HFOV, MAP and FiO2 are the keys for maintaining oxygenation, and amplitude/power and frequency play major roles for ventilation. The use of HFOV on neonates may be of elective or rescue purpose. Reported randomized clinical trials in neonates have found positive, negative and null results in the use of HFOV. However, these trials support that HFOV is safe for neonatal use although there was no overall benefits. Further studies regarding details on the management strategies, such as time of starting HFOV, pulmonary disease origins, ventilator settings, ventilator types, and outcome definitions may help to guide neonatologist in caring neonates with acute pulmonary dysfunction.
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