High frequency oscillatory ventilation and hyaline membrane disease

A total of 14 newborn infants suffering for severe hyaline membrane disease (HMD) has been ventilated with high frequency oscillatory ventilation (HFOV). The mean birth weight and gestational age were respectively 1313 +/- 560 g (range 643-2249 g) and 30 +/- 3 weeks (range 26-36 weeks). HFOV has been utilised when traditional ventilation and administration of exogenous surfactant lead to unsatisfactorily results. A significant improvement of oxygenation (increase of PaO2 from 67 +/- 18 to 102 +/- 37 mmHg, p = 0.004) and ventilation (PaCO2 reduced from 48 +/- 14 to 33 +/- 11 mmHg, p = 0.007) has been reached in the first 6 hours of HFOV. This good result has been confirmed by the reduction of alveolar-arterial gradient of oxygen from 369 +/- 135 to 85 +/- 102 (p = 0.0001, one-way ANOVA) and of the fraction of inspired oxygen from 0.72 +/- 0.2 to 0.30 +/- 0.1 (p = 0.0001, one-way ANOVA) at 48 hours of HFOV. Further 23 infants similar for gestational age, birth weight, severity of HMD, surfactant treatement, but ventilated with conventional devices were analysed and compared with the infants who underwent HFOV. The lenght of mechanical ventilation was significantly shorter in the latter group (286 +/- 150 vs 450 +/- 221 hours, p < 0.05). In conclusion HFOV resulted to be a useful ventilation tool in the infants studied. The possibility to reduce the lenght of mechanical ventilation seems to be of particular interest.