Fischer Hendrik Stefan, Bohlin Kajsa, Bührer Christoph, Schmalisch Gerd, Cremer Malte, Reiss Irwin, Czernik Christoph
Department of Neonatology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany,
Eur J Pediatr. 2015 Apr;174(4):465-71. doi: 10.1007/s00431-014-2419-y. Epub 2014 Sep 18.
Nasal high-frequency oscillation ventilation (nHFOV) is a non-invasive ventilation mode that applies an oscillatory pressure waveform to the airways using a nasal interface. nHFOV has been shown to facilitate carbon dioxide expiration, but little is known about its use in neonates. In a questionnaire-based survey, we assessed nHFOV use in neonatal intensive care units (NICUs) in Austria, Switzerland, Germany, the Netherlands, and Sweden. Questions included indications for nHFOV, equipment used, ventilator settings, and observed side effects. Of the clinical directors of 186 NICUs contacted, 172 (92 %) participated. Among those responding, 30/172 (17 %) used nHFOV, most frequently in premature infants <1500 g (27/30) for the indication nasal continuous positive airway pressure (nCPAP) failure (27/30). Binasal prongs (22/30) were the most common interfaces. The median (range) mean airway pressure when starting nHFOV was 8 (6-12) cm H2O, and the maximum mean airway pressure was 10 (7-18) cm H2O. The nHFOV frequency was 10 (6-13) Hz. Abdominal distension (11/30), upper airway obstruction due to secretions (8/30), and highly viscous secretions (7/30) were the most common nHFOV side effects.
In a number of European NICUs, clinicians use nHFOV. The present survey identified differences in nHFOV equipment, indications, and settings. Controlled clinical trials are needed to investigate the efficacy and side effects of nHFOV in neonates.
经鼻高频振荡通气(nHFOV)是一种无创通气模式,通过鼻接口向气道施加振荡压力波形。已证明nHFOV有助于二氧化碳排出,但对其在新生儿中的应用了解甚少。在一项基于问卷的调查中,我们评估了奥地利、瑞士、德国、荷兰和瑞典新生儿重症监护病房(NICU)中nHFOV的使用情况。问题包括nHFOV的适应证、使用的设备、呼吸机设置以及观察到的副作用。在所联系的186个NICU的临床主任中,172人(92%)参与了调查。在这些回复者中,30/172(17%)使用nHFOV,最常用于体重<1500g的早产儿(27/30),适应证为鼻持续气道正压通气(nCPAP)失败(27/30)。双侧鼻导管(22/30)是最常见的接口。开始nHFOV时的中位(范围)平均气道压为8(6 - 12)cmH₂O,最大平均气道压为10(7 - 18)cmH₂O。nHFOV频率为10(6 - 13)Hz。腹胀(11/30)、因分泌物导致的上气道阻塞(8/30)和高黏稠分泌物(7/30)是nHFOV最常见的副作用。
在一些欧洲NICU中,临床医生使用nHFOV。本次调查确定了nHFOV设备使用、适应证和设置方面的差异。需要进行对照临床试验来研究nHFOV在新生儿中的疗效和副作用。