Comparison of respiratory indices in predicting response to high frequencyoscillatory ventilation in very low birth weight infants with respiratory distress syndrome
Sy. Ko et al., Comparison of respiratory indices in predicting response to high frequencyoscillatory ventilation in very low birth weight infants with respiratory distress syndrome, J KOR MED S, 15(2), 2000, pp. 153-158
To evaluate the predictive values of oxygenation index (OI), arterial-alveo
lar oxygen tension ratio (a/APO)(2), and alveolar-arterial oxygen gradient
((A-a)DO2) for early recognition of responsiveness to high frequency oscill
atory ventilation (HFOV) in very low birth weight infants with respiratory
distress syndrome (RDS), 23 infants who received HFOV treatment for severe
RDS after failing to be improved with conventional mechanical ventilation f
rom July 1995 to February 1998 were included, Twelve infants survived with
HFOV (Responder group), while 11 infants could not maintain oxygenation wit
h HFOV and died (Non-responder group). Clinical record (of each patient) we
re retrospectively reviewed and compared with the respiratory indices. Mean
(A-a)DO2 was significantly lower in the responder group than in the non-re
sponder group at 2 hr after HFOV (p=0.024), and the difference was more rem
arkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2
hr after HFOV therapy was 100% in sensitivity and 80% in specificity. The
earliest significant difference of mean a/APO(2) between two groups was not
ed at 6 hr after HFOV treatment (p=0.019). OI showed no significant differe
nces between two groups. In summary, (A-a)DO2 was the most effective and se
nsitive respiratory index for predicting the responsiveness to HFOV in infa
nts with severe RDS providing clue as early as 2 hr.