Potential role of high-frequency ventilation in the treatment of severe congenital pleural effusion

Newborns with severe congenital pleural effusions often present with respir atory failure at birth. We describe two premature infants horn at 31 and 33 weeks of gestation with bilateral pleural effusions. Both were drained pri or to delivery under ultrasound guidance. The first infant had severe bilat eral congenital chylothorax with pulmonary hypertension; the second infant had severe nonimmune hydrops fetalis. Both could be adequately oxygenated b ut failed to respond to conventional mechanical ventilation (CMV) and chest tube drainage, so that CO, elimination could not be accomplished. Both inf ants were successfully treated with high-frequency ventilation (HFV). We su ggest that HN may be of significant value in establishing adequate ventilat ion in cases of severe congenital pleural effusions. Pediatr Pulmonol, 2000 ; 29:494-408, (C) 2000 Wiley-Liss, Inc.