HIGH-FREQUENCY OSCILLATORY VENTILATION - INITIAL EXPERIENCE IN 22 PATIENTS

Objectives: To report the outcome of a consecutive cohort of neonates treated with high frequency oscillatory ventilation (HFOV). Methodolog y: Prospective cohort study of 22 neonates failing conventional mechan ical ventilation (CMV) between October 1992 and August 1993. Outcomes evaluated were in-hospital survival rate, comorbidities including pate nt ductus arteriosus (PDA), cerebroventricular haemorrhages (CVH), nec rotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and ret inopathy of prematurity (ROP), and acute changes in respiratory status . Results: Eighteen of 22 (81.8%) survived. Of the four children who d ied, one did not respond to HFOV and died within 24 h of treatment. Tw o died of respiratory failure complicated by pulmonary haemorrhage. Th e remaining infant responded to HFOV but later developed severe NEC wh ile on minimal CMV and died at 2 weeks of age. Three subjects were gre ater than or equal to 34 weeks' gestation; each responded well to HFOV with no substantial comorbidity. Of the remaining 19 infants <34 week s' gestation, six (31.6%) had a PDA, and seven (36.8%) had a CVH. One infant developed cystic periventricular leucomalacia. Three infants (1 5.8%) had NEC. Respiratory failure in the 15 survivors with gestationa l ages <34 weeks improved dramatically with HFOV. Ten (66.7%) survivor s <34 weeks developed BPD and 10 (66.7%) ROP. Conclusion: High frequen cy oscillatory ventilation was associated with a survival rate of 81.8 %, but with significant comorbidity.