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High Frequency Oscillatory Ventilation as a Rescue Therapy of Severe Neonatal Respiratory Failure

Journal of the Korean Pediatric Society 1998;41(4):456-465.
Published online April 15, 1998.
High Frequency Oscillatory Ventilation as a Rescue Therapy of Severe Neonatal Respiratory Failure
Eun Kyung Lee, Yun Sil Chang, Won Soon Park
Department of pediatrics, College of Medicine, Sung Kyun Kwan University, Samsung Medical Centerm Seoul, Korea
심한 신생아 호흡부전에서 고빈도 진동성 인공환기요법의 치료효과
이은경, 장윤실, 박원순
성균관대학교 의과대학 삼성서울병원 소아과
Correspondence: 
Eun Kyung Lee, Tel: +82.2-3468-3107, Fax: +82.2-558-1119, 
Abstract
Purpose
: High frequency oscillatory ventilation(HFOV) using suprathysiologic ventilatory frequency is a new therapeutic technique, which has a improved survival and reduced complication of newborn infants suffering from severe respiratory failure. The aim of this study was to assess the efficacy of HFOV as a rescue therapy for infants with severe respiratory failure and to compare the treatment results of several types of respiratory diseases.
Methods
: Retrospective analysis of the medical records of neonates who were admitted due to severe respiratory failure, they had an arterio-alveolar oxygen tension ratio below 0.25 despite of conventional mechanical venrilation.
Results
: twenty-two neonates(survivor group 15, nonsurvivor group 7) were evaluated. HFOV treatment was initianted at 4.0¡¾4.6 days after birth in survivor group, and 4.4¡¾3.1 days in nonsurvivor group. Plmonary hemorrhage and airleak syndrome is the most common indication of HFOV. The highest survival rate was 75.0% in homogenous lung diseases. The oxygenation index after 12 hours and a/APO2 after 6 hours on HFOV were significantly higher in those infants who survived, compared to those who died(P<0.05). The complications after HFOV were pneumothorax(survivor group 1, nonsurvivor group 3) and bronchopulmonary dyslasia(survivr group 5 nonsurvivor group 2).
Conclusion
: We concluded that high frequency oscillatiory ventilation significantly improves oxygenation in neonates with severe pulmonary disease, who did not respond to conventional mechanical cenrilator therapy, and is useful as a rescue therapy in severe neonetal respiratory failure.
Key Words: High frequency oscillatory ventilation, Neomate, Respiratory failure


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