The Use of Noninvasive Ventilation with High Frequency in Newborns—A Single-Center Experience

Beata Łoniewska; Joanna Tousty; Barbara Michalczyk; Agnieszka Kordek; Agata Jankowska

doi:10.1055/s-0038-1677471

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2019; 36(13): 1362-1367
DOI: 10.1055/s-0038-1677471

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Use of Noninvasive Ventilation with High Frequency in Newborns—A Single-Center Experience

Beata Łoniewska

¹Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland

,

Joanna Tousty

²Department of Neonatal Diseases, Samodzielny Publiczny Szpital Kliniczny nr 2 Pomorskiego Uniwersytetu Medycznego, Szczecin, Zachodniopomorskie, Poland

,

Barbara Michalczyk

¹Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland

,

Agnieszka Kordek

¹Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland

,

Agata Jankowska

²Department of Neonatal Diseases, Samodzielny Publiczny Szpital Kliniczny nr 2 Pomorskiego Uniwersytetu Medycznego, Szczecin, Zachodniopomorskie, Poland

› Institutsangaben

Abstract

Objective The aim of the study is to evaluate the efficacy of noninvasive high-frequency ventilation (nHFV) in respiratory-deficient infants.

Study Design Retrospective analysis of 32 cases of nHFV in 30 term (n = 4) and preterm (n = 26) newborns using a noninvasive ventilation (NIV) device. nHFV avoided intubation of children performed with NIV and reintubation after long-term mechanical ventilation (MV). Patients were divided into three groups: Group 1: NIV from birth (n = 18, mean birth weight [BW]: 1,987 g, gestational age [GA]: 33.1 weeks); Group 2: MV, also used temporarily, and NIV (n = 10, BW: 1,074 g, GA: 28.2 weeks); and Group 3: two cases with nHFV avoided reintubation after long-term MV (BW: 725 g, GA: 24.5 weeks).

Results From 32 episodes of nHFV application, positive effect was achieved 26 times (81%) (24 of 30 children). All newborns had a significant increase in pH (7.23–7.27) and reduction in partial pressure of CO₂ (66.7–58.9 mm Hg, over 1–2 hours). Failures in application of nHFV reported only in Group 1 (6/18, 33%) (failures primarily due to increasing demand for oxygen). There were two reports of pneumothorax in preterm infants with congenital pneumonia. No other nHFV-related complications were noted.

Conclusion nHFV is a promising NIV mode which can be also used with NIV devices.

Keywords

noninvasive high-frequency ventilation - noninvasive ventilation - newborns - mechanical ventilation

Volltext

Referenzen

References
1 Fan E, Villar J, Slutsky AS. Novel approaches to minimize ventilator-induced lung injury. BMC Med 2013; 11 (11) 85
2 Bhandari V. The potential of non-invasive ventilation to decrease BPD. Semin Perinatol 2013; 37 (02) 108-114
3 Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS. ; NIPPV Study Group. A trial comparing noninvasive ventilation strategies in preterm infants. N Engl J Med 2013; 369 (07) 611-620
4 Null DM, Alvord J, Leavitt W. , et al. High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs. Pediatr Res 2014; 75 (04) 507-516
5 De Luca D, Piastra M, Pietrini D, Conti G. Effect of amplitude and inspiratory time in a bench model of non-invasive HFOV through nasal prongs. Pediatr Pulmonol 2012; 47 (10) 1012-1018
6 Klotz D, Schaefer C, Stavropoulou D, Fuchs H, Schumann S. Leakage in nasal high-frequency oscillatory ventilation improves carbon dioxide clearance-A bench study. Pediatr Pulmonol 2017; 52 (03) 367-372
7 Colaizy TT, Younis UM, Bell EF, Klein JM. Nasal high-frequency ventilation for premature infants. Acta Paediatr 2008; 97 (11) 1518-1522
8 Fischer HS, Bohlin K, Bührer C. , et al. Nasal high-frequency oscillation ventilation in neonates: a survey in five European countries. Eur J Pediatr 2015; 174 (04) 465-471
9 Rehan VK, Fong J, Lee R. , et al. Mechanism of reduced lung injury by high-frequency nasal ventilation in a preterm lamb model of neonatal chronic lung disease. Pediatr Res 2011; 70 (05) 462-466
10 Aspros AJ, Coto CG, Lewis JF, Veldhuizen RA. High-frequency oscillation and surfactant treatment in an acid aspiration model. Can J Physiol Pharmacol 2010; 88 (01) 14-20
11 van der Hoeven M, Brouwer E, Blanco CE. Nasal high frequency ventilation in neonates with moderate respiratory insufficiency. Arch Dis Child Fetal Neonatal Ed 1998; 79 (01) F61-F63
12 Czernik C, Schmalisch G, Bührer C, Proquitté H. Weaning of neonates from mechanical ventilation by use of nasopharyngeal high-frequency oscillatory ventilation: a preliminary study. J Matern Fetal Neonatal Med 2012; 25 (04) 374-378
13 Mukerji A, Singh B, Helou SE. , et al. Use of noninvasive high-frequency ventilation in the neonatal intensive care unit: a retrospective review. Am J Perinatol 2015; 30 (02) 171-176
14 Mukerji A, Sarmiento K, Lee B, Hassall K, Shah V. Non-invasive high-frequency ventilation versus bi-phasic continuous positive airway pressure (BP-CPAP) following CPAP failure in infants <1250 g: a pilot randomized controlled trial. J Perinatol 2017; 37 (01) 49-53
15 De Luca D, Carnielli VP, Conti G, Piastra M. Noninvasive high frequency oscillatory ventilation through nasal prongs: bench evaluation of efficacy and mechanics. Intensive Care Med 2010; 36 (12) 2094-2100
16 Aktas S, Unal S, Aksu M. , et al. Nasal HFOV with binasal cannula appears effective and feasible in ELBW newborns. J Trop Pediatr 2016; 62 (02) 165-168
17 De Luca D, Dell'Orto V. Non-invasive high-frequency oscillatory ventilation in neonates: review of physiology, biology and clinical data. Arch Dis Child Fetal Neonatal Ed 2016; pii: fetalneonatal-2016-310664
18 Mukerji A, Finelli M, Belik J. Nasal high-frequency oscillation for lung carbon dioxide clearance in the newborn. Neonatology 2013; 103 (03) 161-165
19 Dumas De La Roque E, Bertrand C, Tandonnet O. , et al. Nasal high frequency percussive ventilation versus nasal continuous positive airway pressure in transient tachypnea of the newborn: a pilot randomized controlled trial (NCT00556738). Pediatr Pulmonol 2011; 46 (03) 218-223