High-frequency ventilation in premature infants with lung disease: adequate gas exchange at low tracheal pressure.

The technique of high-frequency ventilation (HFV) was used in ten infants with severe respiratory distress syndrome and five infants with pulmonary interstitial emphysema (PIE). The mean frequency used was 12 Hz (720/min). Peak tracheal pressure for the infants with respiratory distress syndrome was 28 +/- 4 (SD) cm H2O on conventional ventilation, and 22 +/- 4 cm H2O on HFV (P less than .05). For the infants with PIE, peak tracheal pressure decreased from 38 +/- 11 to 24 +/- 5 cm H2O (P less than .05). Mean tracheal pressure was the same for the two types of ventilation. No adverse clinical or pathologic side effects were seen. Clinical and radiologic improvements were seen in the infants with PIE after initiation of HFV. It is believed that these improvements in the patients with PIE were secondary to the decrease in tracheal pressure and that HFV may have a role in treatment of preexisting barotrauma and its prevention. These studies contribute to the preliminary data necessary before controlled trials of HFV in infants with respiratory distress syndrome and PIE can be carried out.