[Mechanical ventilation in pediatrics (III). Weaning, complications and other types of ventilation. High-frequency ventilation]

Nuestra experiencia con la ventilación de alta frecuencia oscilatoria

INTRODUCTION

High-frequency oscillatory ventilation is a safe and effective means of delivering mechanical ventilatory support.

OBJECTIVE

To evaluate the safety and effectiveness of high-frequency oscillatory ventilation in pediatric patients with acute respiratory failure.

PATIENTS AND METHOD

From August 2003 to July 2005, we performed a prospective observational study of 11 children older than 1 month who underwent high-frequency oscillatory ventilation. Pediatric risk of mortality scores (PRISM), Murray lung-injury scores and air leak scores were recorded at baseline before ventilation. The following variables were studied: ventilatory settings (FiO2 and mean airway pressure), gasometric (PaO2, SaO2, PaCO2, pHa, PaO2/FiO2 ratio) and hemodynamic parameters (Partm, PVC), and the oxygenation index.

RESULTS

The overall survival rate was 82 %. Significant increases were found in PaO2 (p < 0.05), SaO2 (p < 0.05) and the PaO2/FiO2 ratio (p < 0.05), while mean airway pressure (p < 0.001), oxygenation index (p < 0.001), and FiO2 (p < 0.001) significantly decreased over time.

CONCLUSIONS

High-frequency oscillatory ventilation significantly improved oxygenation in children with acute hypoxemic respiratory failure.