Background: The effects of high-frequency oscillatory ventilation (HFOV) on
hemodynamic parameters have been shown in animal as well as in clinical st
udies. In a further study we could demonstrate, that after change of a conv
entionel positive pressure ventilation (CMV) to HFOV flow velocities in cer
ebral arteries decreased. In the following we added to the dopplerflow meth
od the continuous examination of cerebral oxygenation with near infrared sp
ectroscopy (NIRS). Patients: 19 measurements were prospectively conducted i
n 18 neonates. The infants were mechanically ventilated with HFOV and were
in a stable condition. Methods: Before change from HFOV to CMV doppler sign
als of the anterior cerebral artery were measured. We repeated this at the
end of the study in each patient. NIRS-optodes were placed on the front and
the os parietale of each infant. After stabilisation of the system we chan
ged from HFOV to CMV without disconnection of the patient from the machine.
PCO2 was registred continously via a transcutaneous probe, as well as oxyg
en saturation via pulse oxymetry. Statistical analysis was performed with W
ilcoxon test. Results: There were no significant changes of doppler-signals
during the study (median vs. 25 cm/s (+/- 6) during HFOV, 28 cm/s (+/-/) d
uring CMV). The parameter of NIRS, oxygenated hemoglobin HbO [-1.5U (+/-22.
78)] at 15 minutes after change), reduced hemoglobin HbR [-1.17 U (+/- 5.26
)] and total hemoglobin HbT [-2.68 U (+/- 18.7)] remained stable during the
change from HFOV to CWV, too. In five infants there was a decrease and in
two an increase of HbO 15 minutes after change, which correlated with decre
ase or increase of pCO(2). Conclusion: In a combined measurement of doppler
flow and NIRS we found no special effect of HFOV on cerebral hemodynamics c
omparing with CMV. Changes of cerebral oxygenation in NIRS correlated with
pCO(2).