Controlled Prospective Randomized Comparison of High-Frequency Jet Ventilation and Conventional Ventilation in Neonates with Respiratory Failure and Persistent Pulmonary Hypertension

W. A. Engle, Mervin Yoder, Sharon Andreoli, R. K. Darragh, C. D. Langefeld, Siu Hui

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Abstract

OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of high-frequency jet ventilation in near-term and term neonates with persistent pulmonary hypertension. STUDY DESIGN: Subjects for this prospective, randomized, controlled comparison study were recruited from neonates treated in a level-three neonatal intensive care unit that accepts referrals for extracorporeal membrane oxygenation. RESULTS: In patients treated with high-frequency jet ventilation (n = 11) acute improvement in oxygenation (p = 0.008), ventilation (p < 0.001), and oxygen indices (p ≤ 0.01) was demonstrated while stable peak and mean airway pressures were maintained. Control group patients receiving high-frequency positive pressure ventilation with a conventional ventilator required increasingly higher peak inspiratory pressures (p = 0.005) to maintain oxygenation, ventilation, and oxygen indices. There were no significant differences in survival without use of extracorporeal membrane oxygenation, nor were there differences in duration of oxygen therapy, ventilation, and hospitalization; need for extacorporeal membrane oxygenation; or incidence of chronic lung disease. CONCLUSIONS: High-frequency jet ventilation acutely improves oxygenation and ventilation without significantly increasing morbidity. Therefore high-frequency jet ventilation may be a useful adjunct for stabilization of the conditions of neonates with severe persistent pulmonary hypertension. Conclusions about the efficacy of high-frequency jet ventilation in improving survival without the need for extracorporeal membrane oxygenation await multicentered, collaborative investigations with large cohorts of patients.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalJournal of Perinatology
Volume17
Issue number1
StatePublished - Jan 1997

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High-Frequency Jet Ventilation
Pulmonary Hypertension
Respiratory Insufficiency
Ventilation
Extracorporeal Membrane Oxygenation
Newborn Infant
Oxygen
High-Frequency Ventilation
Pressure
Survival
Neonatal Intensive Care Units
Mechanical Ventilators
Lung Diseases
Hospitalization
Chronic Disease
Referral and Consultation
Morbidity
Safety
Control Groups
Membranes

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Controlled Prospective Randomized Comparison of High-Frequency Jet Ventilation and Conventional Ventilation in Neonates with Respiratory Failure and Persistent Pulmonary Hypertension",
abstract = "OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of high-frequency jet ventilation in near-term and term neonates with persistent pulmonary hypertension. STUDY DESIGN: Subjects for this prospective, randomized, controlled comparison study were recruited from neonates treated in a level-three neonatal intensive care unit that accepts referrals for extracorporeal membrane oxygenation. RESULTS: In patients treated with high-frequency jet ventilation (n = 11) acute improvement in oxygenation (p = 0.008), ventilation (p < 0.001), and oxygen indices (p ≤ 0.01) was demonstrated while stable peak and mean airway pressures were maintained. Control group patients receiving high-frequency positive pressure ventilation with a conventional ventilator required increasingly higher peak inspiratory pressures (p = 0.005) to maintain oxygenation, ventilation, and oxygen indices. There were no significant differences in survival without use of extracorporeal membrane oxygenation, nor were there differences in duration of oxygen therapy, ventilation, and hospitalization; need for extacorporeal membrane oxygenation; or incidence of chronic lung disease. CONCLUSIONS: High-frequency jet ventilation acutely improves oxygenation and ventilation without significantly increasing morbidity. Therefore high-frequency jet ventilation may be a useful adjunct for stabilization of the conditions of neonates with severe persistent pulmonary hypertension. Conclusions about the efficacy of high-frequency jet ventilation in improving survival without the need for extracorporeal membrane oxygenation await multicentered, collaborative investigations with large cohorts of patients.",
author = "Engle, {W. A.} and Mervin Yoder and Sharon Andreoli and Darragh, {R. K.} and Langefeld, {C. D.} and Siu Hui",
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T1 - Controlled Prospective Randomized Comparison of High-Frequency Jet Ventilation and Conventional Ventilation in Neonates with Respiratory Failure and Persistent Pulmonary Hypertension

AU - Engle, W. A.

AU - Yoder, Mervin

AU - Andreoli, Sharon

AU - Darragh, R. K.

AU - Langefeld, C. D.

AU - Hui, Siu

PY - 1997/1

Y1 - 1997/1

N2 - OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of high-frequency jet ventilation in near-term and term neonates with persistent pulmonary hypertension. STUDY DESIGN: Subjects for this prospective, randomized, controlled comparison study were recruited from neonates treated in a level-three neonatal intensive care unit that accepts referrals for extracorporeal membrane oxygenation. RESULTS: In patients treated with high-frequency jet ventilation (n = 11) acute improvement in oxygenation (p = 0.008), ventilation (p < 0.001), and oxygen indices (p ≤ 0.01) was demonstrated while stable peak and mean airway pressures were maintained. Control group patients receiving high-frequency positive pressure ventilation with a conventional ventilator required increasingly higher peak inspiratory pressures (p = 0.005) to maintain oxygenation, ventilation, and oxygen indices. There were no significant differences in survival without use of extracorporeal membrane oxygenation, nor were there differences in duration of oxygen therapy, ventilation, and hospitalization; need for extacorporeal membrane oxygenation; or incidence of chronic lung disease. CONCLUSIONS: High-frequency jet ventilation acutely improves oxygenation and ventilation without significantly increasing morbidity. Therefore high-frequency jet ventilation may be a useful adjunct for stabilization of the conditions of neonates with severe persistent pulmonary hypertension. Conclusions about the efficacy of high-frequency jet ventilation in improving survival without the need for extracorporeal membrane oxygenation await multicentered, collaborative investigations with large cohorts of patients.

AB - OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of high-frequency jet ventilation in near-term and term neonates with persistent pulmonary hypertension. STUDY DESIGN: Subjects for this prospective, randomized, controlled comparison study were recruited from neonates treated in a level-three neonatal intensive care unit that accepts referrals for extracorporeal membrane oxygenation. RESULTS: In patients treated with high-frequency jet ventilation (n = 11) acute improvement in oxygenation (p = 0.008), ventilation (p < 0.001), and oxygen indices (p ≤ 0.01) was demonstrated while stable peak and mean airway pressures were maintained. Control group patients receiving high-frequency positive pressure ventilation with a conventional ventilator required increasingly higher peak inspiratory pressures (p = 0.005) to maintain oxygenation, ventilation, and oxygen indices. There were no significant differences in survival without use of extracorporeal membrane oxygenation, nor were there differences in duration of oxygen therapy, ventilation, and hospitalization; need for extacorporeal membrane oxygenation; or incidence of chronic lung disease. CONCLUSIONS: High-frequency jet ventilation acutely improves oxygenation and ventilation without significantly increasing morbidity. Therefore high-frequency jet ventilation may be a useful adjunct for stabilization of the conditions of neonates with severe persistent pulmonary hypertension. Conclusions about the efficacy of high-frequency jet ventilation in improving survival without the need for extracorporeal membrane oxygenation await multicentered, collaborative investigations with large cohorts of patients.

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