Johnston D, Hochmann M, Timms B
Department of Neonatology, Royal Women's Hospital, Carlton, Vic., Australia.
J Paediatr Child Health. 1995 Aug;31(4):297-301. doi: 10.1111/j.1440-1754.1995.tb00815.x.
To report the outcome of a consecutive cohort of neonates treated with high frequency oscillatory ventilation (HFOV).
Prospective cohort study of 22 neonates failing conventional mechanical ventilation (CMV) between October 1992 and August 1993. Outcomes evaluated were in-hospital survival rate, comorbidities including patent ductus arteriosus (PDA), cerebroventricular haemorrhages (CVH), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP), and acute changes in respiratory status.
Eighteen of 22 (81.8%) survived. Of the four children who died, one did not respond to HFOV and died within 24 h of treatment. Two died of respiratory failure complicated by pulmonary haemorrhage. The remaining infant responded to HFOV but later developed severe NEC while on minimal CMV and died at 2 weeks of age. Three subjects were > or = 34 weeks' gestation; each responded well to HFOV with no substantial comorbidity. Of the remaining 19 infants < 34 weeks' gestation, six (31.6%) had a PDA, and seven (36.8%) had a CVH. One infant developed cystic periventricular leucomalacia. Three infants (15.8%) had NEC. Respiratory failure in the 15 survivors with gestational ages < 34 weeks improved dramatically with HFOV. Ten (66.7%) survivors < 34 weeks developed BPD and 10 (66.7%) ROP.
High frequency oscillatory ventilation was associated with a survival rate of 81.8%, but with significant comorbidity.
报告连续一组接受高频振荡通气（HFOV）治疗的新生儿的治疗结果。
对1992年10月至1993年8月期间22例常规机械通气（CMV）失败的新生儿进行前瞻性队列研究。评估的结果包括住院生存率、合并症，如动脉导管未闭（PDA）、脑室出血（CVH）、坏死性小肠结肠炎（NEC）、支气管肺发育不良（BPD）和早产儿视网膜病变（ROP），以及呼吸状态的急性变化。
22例中有18例（81.8%）存活。4例死亡患儿中，1例对HFOV无反应，在治疗后24小时内死亡。2例死于呼吸衰竭并发肺出血。其余1例婴儿对HFOV有反应，但在接受最小剂量CMV治疗时后来发展为严重NEC，并在2周龄时死亡。3例胎龄≥34周；每例对HFOV反应良好，无明显合并症。其余19例胎龄<34周的婴儿中，6例（31.6%）患有PDA，7例（36.8%）患有CVH。1例婴儿发生脑室周围囊性白质软化。3例婴儿（15.8%）患有NEC。胎龄<34周的15例存活者的呼吸衰竭通过HFOV得到显著改善。10例（66.7%）胎龄<34周的存活者发生BPD，10例（66.7%）发生ROP。
高频振荡通气的生存率为81.8%，但合并症严重。
