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

W. A. Engle, M. C. Yoder, S. P. Andreoli, R. K. Darragh, C. D. Langefeld, S. L. Hui

Research output: Contribution to journalArticle

42 Scopus citations

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 (US)
Pages (from-to)3-9
Number of pages7
JournalJournal of Perinatology
Volume17
Issue number1
StatePublished - Jan 1 1997

ASJC Scopus subject areas

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

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