Amit Mukerji1, Balpreet Singh2, Salhab El Helou2, Christoph Fusch2, Michael Dunn3, Jaques Belik1, Vibhuti Shah4. 1. Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada. 2. Department of Paediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada. 3. Department of Paediatrics, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. 4. Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: The aim of the article is to review the effectiveness of neonatal noninvasive high-frequency ventilation (NIHFV) in preventing endotracheal mechanical ventilation. STUDY DESIGN: Retrospective case series including all 79 instances of NIHFV use at four participating centers between July 2010 and September 2012. RESULTS: In 73% of cases, NIHFV was used as rescue after another noninvasive mode, and prophylactically (postextubation) in the remainder. In 58% of cases, infants transitioned to another noninvasive mode, without requiring intubation. There were significant reductions in the mean (SD) number of apneas, bradycardias, or desaturations (over 6 hours) (3.2 [0.4] vs. 1.2 [0.3]; p < 0.001), FiO2 (48 [3] vs. 40 [2]%; p < 0.001) and CO2 levels (74 [6] vs. 62 [4] mm Hg; p = 0.025] with NIHFV. No NIHFV-related complications were noted. CONCLUSIONS: NIHFV is a promising NIV mode that may help prevent or delay intubation and deserves further clinical research. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: The aim of the article is to review the effectiveness of neonatal noninvasive high-frequency ventilation (NIHFV) in preventing endotracheal mechanical ventilation. STUDY DESIGN: Retrospective case series including all 79 instances of NIHFV use at four participating centers between July 2010 and September 2012. RESULTS: In 73% of cases, NIHFV was used as rescue after another noninvasive mode, and prophylactically (postextubation) in the remainder. In 58% of cases, infants transitioned to another noninvasive mode, without requiring intubation. There were significant reductions in the mean (SD) number of apneas, bradycardias, or desaturations (over 6 hours) (3.2 [0.4] vs. 1.2 [0.3]; p < 0.001), FiO2 (48 [3] vs. 40 [2]%; p < 0.001) and CO2 levels (74 [6] vs. 62 [4] mm Hg; p = 0.025] with NIHFV. No NIHFV-related complications were noted. CONCLUSIONS:NIHFV is a promising NIV mode that may help prevent or delay intubation and deserves further clinical research. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.