High frequency oscillatory ventilation in respiratory treatment of neonates with severe respiratory distress-syndrome

Abstract

The respiratory distress syndrome most commonly defines the severity of condition in neonates, especially in prematures. In this situation the conventional ventilation may have low efficacy and can be followed by enough severe complications. As the alternative to conventional ventilation we used high-frequency oscillatory ventilation provided by Sensor-Medics 3100A ventilator.

Full Text

Basic indications to HFOV were severe RDS, massive meconium aspiration syndrome (MAS), congenital malformations complicated by increased elevated pulmonary vascular pressure and pulmonary shunting (congenital diaphragmal hernia). We used HFOV in 50 neonates, 75% of them developed severe RDS and had the birth weight less than 2 kg.

We noticed definite rapid positive changes in 70% of patients receiving HFOV combined with surfactant replacement therapy (Exosurft). The criteria of efficacy were changes in arterial blood gases, x-ray pictures, improvement of hemodynamics.

We also noticed significantly less such severe complications as intestinal emphysema, pneumothorax and bronchopulmonary dysplasia. We also get the possibility to rapid decrease oxygen concentration down to 21%. The amount of severe neurological complications (such as intraventricular hemorrhages, periventricular leukomalacia, and brain edema) also decreased when the severe RDS resolved rapidly.

The obtained data give us the possibility to consider the HFOV as a prospective advanced therapy of neonatal RDS.