HIGH-FREQUENCY OSCILLATION IN NEWBORN-INFANTS WITH RESPIRATORY-FAILURE

Objective: To report Ventilation strategies, survival and complications in 39 outborn infants treated with high frequency oscillatory ventilation (HFOV). Methodology: Data were collected prospectively between 1 May 1992 and 31 December 1993 on all infants treated with HFOV who had severe respiratory failure despite optimal conventional ventilation. Results: Twenty-eight out of 39 (72%) survived. Of the 15 infants with birthweights <1500 g, eight survived. Best survival rates were for infants with pulmonary interstitial emphysema with air leak (4/5) and for infants of birthweight > 1500 g with hyaline membrane disease (8/8), and meconium aspiration syndrome (7/7). Three infants deteriorated while on HFOV and required extracorporeal membrane oxygenation. Complications were: (i) development of pulmonary interstitial emphysema (1); (ii) recurrence of pneumothorax (3); (iii) hypotension (2); and (iv) bronchopulmonary dysplasia (9). One of the eight infants weighing <1500 g who received HFOV in the first week of life developed periventricular haemorrhage. Conclusion: The initial results of HFOV for severe respiratory failure were encouraging although a learning curve was encountered with its introduction.