Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Zachodniopomorskie, Poland.
Department of Neonatal Diseases, Samodzielny Publiczny Szpital Kliniczny nr 2 Pomorskiego Uniwersytetu Medycznego, Szczecin, Zachodniopomorskie, Poland.
Am J Perinatol. 2019 Nov;36(13):1362-1367. doi: 10.1055/s-0038-1677471. Epub 2019 Jan 8.
The aim of the study is to evaluate the efficacy of noninvasive high-frequency ventilation (nHFV) in respiratory-deficient infants.
Retrospective analysis of 32 cases of nHFV in 30 term ( = 4) and preterm ( = 26) newborns using a noninvasive ventilation (NIV) device. nHFV avoided intubation of children performed with NIV and reintubation after long-term mechanical ventilation (MV). Patients were divided into three groups: Group 1: NIV from birth ( = 18, mean birth weight [BW]: 1,987 g, gestational age [GA]: 33.1 weeks); Group 2: MV, also used temporarily, and NIV ( = 10, BW: 1,074 g, GA: 28.2 weeks); and Group 3: two cases with nHFV avoided reintubation after long-term MV (BW: 725 g, GA: 24.5 weeks).
From 32 episodes of nHFV application, positive effect was achieved 26 times (81%) (24 of 30 children). All newborns had a significant increase in pH (7.23-7.27) and reduction in partial pressure of CO (66.7-58.9 mm Hg, over 1-2 hours). Failures in application of nHFV reported only in Group 1 (6/18, 33%) (failures primarily due to increasing demand for oxygen). There were two reports of pneumothorax in preterm infants with congenital pneumonia. No other nHFV-related complications were noted.
nHFV is a promising NIV mode which can be also used with NIV devices.
本研究旨在评估无创高频通气（nHFV）在呼吸功能不全婴儿中的疗效。
回顾性分析 30 例足月（n=4）和 26 例早产（n=26）新生儿使用无创通气（NIV）设备进行 nHFV 的 32 例病例。nHFV 避免了对接受 NIV 治疗的儿童进行插管，并避免了长期机械通气（MV）后的再次插管。患者分为三组：第 1 组：出生时即开始 NIV（n=18，平均出生体重 [BW]：1987g，胎龄 [GA]：33.1 周）；第 2 组：MV 也暂时使用，随后使用 NIV（n=10，BW：1074g，GA：28.2 周）；第 3 组：2 例经长期 MV 后避免再次插管的 nHFV（BW：725g，GA：24.5 周）。
从 32 例 nHFV 应用中，有 26 次（81%）取得了积极效果（30 例患儿中的 24 例）。所有新生儿的 pH 值（7.23-7.27）显著升高，二氧化碳分压（66.7-58.9mmHg，1-2 小时内）显著降低。仅在第 1 组（n=18，6/18，33%）报告了 nHFV 应用失败（失败主要是由于对氧气的需求增加）。两名患有先天性肺炎的早产儿报告了气胸。未发现其他与 nHFV 相关的并发症。
nHFV 是一种很有前途的 NIV 模式，也可以与 NIV 设备一起使用。
