High-frequency oscillatory ventilators in burn patients: Experience of riley hospital for children

S. Travis Greathouse, Ivan Hadad, Madeline Zieger, Mara Nitu, Courtney M. Rowan, John J. Coleman

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The objective of the study is to review a single institution's experience with high-frequency oscillatory ventilation (HFOV) and compare patient characteristics, outcomes, and complications with other reported studies of HFOV use in burn patients with acute respiratory distress syndrome and respiratory failure. This study is a retrospective chart review of the burn patients treated with HFOV in Pediatric Burn Unit at Riley Hospital for Children from October 1996 to April 2007. Patient data were collected, including demographics, percentage of TBSA burn, percentage of full-thickness burn, mechanisms of burn, settings on conventional mechanical ventilation and HFOV, and blood gas data before initiation of HFOV and at 1, 3, 6, 12, 24, 72 (3 days), 120 (5 days), 168 (7 days), 240 (10 days), and 336 hours (14 days). Length of stay, mortality, and complications were also included. HFOV was used 24 times in 21 patients between October 1996 and April 2007 with a mean age of 10 ± 11 years. At initiation of HFOV, the PaO2/FiO2 and oxygenation index values were 109 ± 26 and 36 ± 12, respectively. At stop, the PaO2/FiO2 improved to 166 ± 24 with an average increase from before HFOV of 57 ± 39 (P < .002). At 5 days of HFOV, oxygenation index improved to 14.1 ± 1.7 (P < .02) but did not significantly improve at discontinuation of HFOV at 28.8 ± 6.2 (P = .11). The mortality rate during admission to the burn unit was 29%. Barotrauma occurred in 38% of patients during HFOV. Severe hypercapnea was present briefly in 49% of patients, and this was refractory to standard treatment in 19%. In our experience, HFOV in severe burn patients has significant, early, and sustained improvement in oxygenation. Earlier institution of HFOV seems to significantly lower rates of barotraumas.

Original languageEnglish
Pages (from-to)425-435
Number of pages11
JournalJournal of Burn Care and Research
Volume33
Issue number3
DOIs
StatePublished - May 2012

Fingerprint

High-Frequency Ventilation
Mechanical Ventilators
Barotrauma
Burn Units
Mortality
Adult Respiratory Distress Syndrome
Artificial Respiration
Respiratory Insufficiency

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

High-frequency oscillatory ventilators in burn patients : Experience of riley hospital for children. / Greathouse, S. Travis; Hadad, Ivan; Zieger, Madeline; Nitu, Mara; Rowan, Courtney M.; Coleman, John J.

In: Journal of Burn Care and Research, Vol. 33, No. 3, 05.2012, p. 425-435.

Research output: Contribution to journalArticle

Greathouse, S. Travis ; Hadad, Ivan ; Zieger, Madeline ; Nitu, Mara ; Rowan, Courtney M. ; Coleman, John J. / High-frequency oscillatory ventilators in burn patients : Experience of riley hospital for children. In: Journal of Burn Care and Research. 2012 ; Vol. 33, No. 3. pp. 425-435.
@article{aeba465377b84c9486c65bd5a31647e6,
title = "High-frequency oscillatory ventilators in burn patients: Experience of riley hospital for children",
abstract = "The objective of the study is to review a single institution's experience with high-frequency oscillatory ventilation (HFOV) and compare patient characteristics, outcomes, and complications with other reported studies of HFOV use in burn patients with acute respiratory distress syndrome and respiratory failure. This study is a retrospective chart review of the burn patients treated with HFOV in Pediatric Burn Unit at Riley Hospital for Children from October 1996 to April 2007. Patient data were collected, including demographics, percentage of TBSA burn, percentage of full-thickness burn, mechanisms of burn, settings on conventional mechanical ventilation and HFOV, and blood gas data before initiation of HFOV and at 1, 3, 6, 12, 24, 72 (3 days), 120 (5 days), 168 (7 days), 240 (10 days), and 336 hours (14 days). Length of stay, mortality, and complications were also included. HFOV was used 24 times in 21 patients between October 1996 and April 2007 with a mean age of 10 ± 11 years. At initiation of HFOV, the PaO2/FiO2 and oxygenation index values were 109 ± 26 and 36 ± 12, respectively. At stop, the PaO2/FiO2 improved to 166 ± 24 with an average increase from before HFOV of 57 ± 39 (P < .002). At 5 days of HFOV, oxygenation index improved to 14.1 ± 1.7 (P < .02) but did not significantly improve at discontinuation of HFOV at 28.8 ± 6.2 (P = .11). The mortality rate during admission to the burn unit was 29{\%}. Barotrauma occurred in 38{\%} of patients during HFOV. Severe hypercapnea was present briefly in 49{\%} of patients, and this was refractory to standard treatment in 19{\%}. In our experience, HFOV in severe burn patients has significant, early, and sustained improvement in oxygenation. Earlier institution of HFOV seems to significantly lower rates of barotraumas.",
author = "Greathouse, {S. Travis} and Ivan Hadad and Madeline Zieger and Mara Nitu and Rowan, {Courtney M.} and Coleman, {John J.}",
year = "2012",
month = "5",
doi = "10.1097/BCR.0b013e31823359ae",
language = "English",
volume = "33",
pages = "425--435",
journal = "Journal of Burn Care and Research",
issn = "1559-047X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - High-frequency oscillatory ventilators in burn patients

T2 - Experience of riley hospital for children

AU - Greathouse, S. Travis

AU - Hadad, Ivan

AU - Zieger, Madeline

AU - Nitu, Mara

AU - Rowan, Courtney M.

AU - Coleman, John J.

PY - 2012/5

Y1 - 2012/5

N2 - The objective of the study is to review a single institution's experience with high-frequency oscillatory ventilation (HFOV) and compare patient characteristics, outcomes, and complications with other reported studies of HFOV use in burn patients with acute respiratory distress syndrome and respiratory failure. This study is a retrospective chart review of the burn patients treated with HFOV in Pediatric Burn Unit at Riley Hospital for Children from October 1996 to April 2007. Patient data were collected, including demographics, percentage of TBSA burn, percentage of full-thickness burn, mechanisms of burn, settings on conventional mechanical ventilation and HFOV, and blood gas data before initiation of HFOV and at 1, 3, 6, 12, 24, 72 (3 days), 120 (5 days), 168 (7 days), 240 (10 days), and 336 hours (14 days). Length of stay, mortality, and complications were also included. HFOV was used 24 times in 21 patients between October 1996 and April 2007 with a mean age of 10 ± 11 years. At initiation of HFOV, the PaO2/FiO2 and oxygenation index values were 109 ± 26 and 36 ± 12, respectively. At stop, the PaO2/FiO2 improved to 166 ± 24 with an average increase from before HFOV of 57 ± 39 (P < .002). At 5 days of HFOV, oxygenation index improved to 14.1 ± 1.7 (P < .02) but did not significantly improve at discontinuation of HFOV at 28.8 ± 6.2 (P = .11). The mortality rate during admission to the burn unit was 29%. Barotrauma occurred in 38% of patients during HFOV. Severe hypercapnea was present briefly in 49% of patients, and this was refractory to standard treatment in 19%. In our experience, HFOV in severe burn patients has significant, early, and sustained improvement in oxygenation. Earlier institution of HFOV seems to significantly lower rates of barotraumas.

AB - The objective of the study is to review a single institution's experience with high-frequency oscillatory ventilation (HFOV) and compare patient characteristics, outcomes, and complications with other reported studies of HFOV use in burn patients with acute respiratory distress syndrome and respiratory failure. This study is a retrospective chart review of the burn patients treated with HFOV in Pediatric Burn Unit at Riley Hospital for Children from October 1996 to April 2007. Patient data were collected, including demographics, percentage of TBSA burn, percentage of full-thickness burn, mechanisms of burn, settings on conventional mechanical ventilation and HFOV, and blood gas data before initiation of HFOV and at 1, 3, 6, 12, 24, 72 (3 days), 120 (5 days), 168 (7 days), 240 (10 days), and 336 hours (14 days). Length of stay, mortality, and complications were also included. HFOV was used 24 times in 21 patients between October 1996 and April 2007 with a mean age of 10 ± 11 years. At initiation of HFOV, the PaO2/FiO2 and oxygenation index values were 109 ± 26 and 36 ± 12, respectively. At stop, the PaO2/FiO2 improved to 166 ± 24 with an average increase from before HFOV of 57 ± 39 (P < .002). At 5 days of HFOV, oxygenation index improved to 14.1 ± 1.7 (P < .02) but did not significantly improve at discontinuation of HFOV at 28.8 ± 6.2 (P = .11). The mortality rate during admission to the burn unit was 29%. Barotrauma occurred in 38% of patients during HFOV. Severe hypercapnea was present briefly in 49% of patients, and this was refractory to standard treatment in 19%. In our experience, HFOV in severe burn patients has significant, early, and sustained improvement in oxygenation. Earlier institution of HFOV seems to significantly lower rates of barotraumas.

UR - http://www.scopus.com/inward/record.url?scp=84861195597&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861195597&partnerID=8YFLogxK

U2 - 10.1097/BCR.0b013e31823359ae

DO - 10.1097/BCR.0b013e31823359ae

M3 - Article

C2 - 21979847

AN - SCOPUS:84861195597

VL - 33

SP - 425

EP - 435

JO - Journal of Burn Care and Research

JF - Journal of Burn Care and Research

SN - 1559-047X

IS - 3

ER -