TY - JOUR
AU1 - Carlo, Waldemar A.
AU2 - Beoglos, Aris
AU3 - Chatburn, Robert L.
AU4 - Walsh, Michele C.
AU5 - Martin, Richard J.
AB - Abstract • To determine if high-frequency jet ventilation is beneficial in neonates with persistent pulmonary hypertension, we compared the ventilator settings, blood gas concentrations, and outcome of infants who met established criteria for a high predictive mortality. During a six-year period, 14 neonates who had severe respiratory failure and hypoxemia while receiving conventional ventilation were treated with high-frequency jet ventilation. Twenty-three comparable infants meeting the same criteria were treated exclusively with conventional ventilation. After initiation of high-frequency jet ventilation there was a significant reduction in mean airway pressure and partial pressure of arterial carbon dioxide (Paco2). In contrast, neonates treated exclusively with conventional ventilation continued to have higher airway pressures and Paco2. However, there was no difference in the alveolar-to-arterial oxygen gradient, air leakage, incidence of bronchopulmonary dysplasia, or duration of assisted ventilation or oxygen supplementation. Furthermore, mortality was comparable in both groups of infants. These preliminary observations suggest that high-frequency jet ventilation can reduce airway pressure and Paco2 in neonates with persistent pulmonary hypertension but does not appear to improve outcome. (AJDC 1989;143:233-238) References 1. Fox WW, Duara S: Persistent pulmonary hypertension in the neonate: Diagnosis and management . J Pediatr 1983;103:505-514.Crossref 2. Bartlett RH, Gazzaniga AB, Toomasian J, et al: Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure . Ann Surg 1986;204:236-244.Crossref 3. Bartlett RH, Roloff DW, Cornell RG, et al: Extracorporeal circulation in neonatal respiratory failure: A prospective study . Pediatrics 1985;76: 479-487. 4. Kirkpatrick BV, Krummel TM, Mueller DG, et al: Use of extracorporeal membrane oxygenation for respiratory failure in term infants . Pediatrics 1983;72:872-876. 5. Lyrene, RK, Welch KA, Godoy, G, et al: Alkalosis attenuates hypoxic pulmonary vasoconstriction in neonatal lambs . Pediatr Res 1985; 19:1268-1271.Crossref 6. Carlo WA, Chatburn RL, Martin RJ, et al: Decrease in airway pressure during high-frequency jet ventilation in infants with respiratory distress syndrome . J Pediatr 1984;104:101-107.Crossref 7. Pagani G, Rezzonico R, Marini A: Trials of high frequency jet ventilation in preterm infants with severe respiratory disease . Acta Paediatr Scand 1985;74:681-686.Crossref 8. Beck R, Anderson KD, Pearson GD, et al: Criteria for extracorporeal membrane oxygenation in population of infants with persistent pulmonary hypertension of the newborn . J Pediatr Surg 1986;21:297-302.Crossref 9. Carlo WA, Chatburn RL, Martin RJ: Randomized trial of high-frequency jet ventilation vs conventional ventilation in respiratory distress syndrome . J Pediatr 1987;110:275-282.Crossref 10. Cornish DJ, Gerstmann DR, Clark RH, et al: Extracorporeal membrane oxygenation and high-frequency oscillatory ventilation: Potential therapeutic relationships . Crit Care Med 1987;15:831-834.Crossref 11. Wung JT, James S, Kilchevsky E, et al: Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation . Pediatrics 1985;76:488-494. 12. Kohelet D, Perlman M, Kirpalani H, et al: High-frequency oscillation in the rescue of infants with persistent pulmonary hypertension . Crit Care Med 1988;16:510-516.Crossref 13. Bohn D, Tamura M, Perrin D, et al: Ventilatory predictors of pulmonary hypoplasia in congenital diaphragmatic hernia, confirmed by morphologic assessment . J Pediatr 1987;111:423-431.Crossref 14. Mammel MC, Boros SJ, Coleman JM, et al: Neonatal high-frequency jet ventilation: Four years' experience . Pediatrics 1985;75:657-663. 15. Boynton BR, Mannino FL, Davis RF, et al: Combined high-frequency oscillatory ventilation and intermittent mandatory ventilation in critically ill neonates . J Pediatr 1984;105:297-302.Crossref 16. Donn SM, Nicks JJ, Bandy KP, et al: Proximal high-frequency jet ventilation of the newborn . Pediatr Pulmonol 1985;1:267-271.Crossref 17. Schumacher RE, Barks, JDE, Johnston MV, et al: Right-sided brain lesions in infants following extracorporeal membrane oxygenation . Pediatrics 1988;82:155-161. 18. Mammel MC, Gordon MJ, Connett JE, et al: Comparison of high-frequency jet ventilation and conventional mechanical ventilation in a meconium aspiration model . J Pediatr 1983; 103:630-634.Crossref 19. Karlson KH, Du Rant RH: High frequency positive pressure ventilation in experimental meconium aspiration syndrome . Am J Med Sci 1986; 29:92-96.Crossref 20. Trindade O, Goldberg RN, Bancalari E, et al: Conventional vs high-frequency jet ventilation in a piglet model of meconium aspiration: Comparison of pulmonary and hemodynamic effects . J Pediatr 1985;107:115-120.Crossref
TI - High-Frequency Jet Ventilation in Neonatal Pulmonary Hypertension
JF - American Journal of Diseases of Children
DO - 10.1001/archpedi.1989.02150140127034
DA - 1989-02-01
UR - https://www.deepdyve.com/lp/american-medical-association/high-frequency-jet-ventilation-in-neonatal-pulmonary-hypertension-nhCKelgjUL
SP - 233
EP - 238
VL - 143
IS - 2
DP - DeepDyve
ER -