High Frequency Oscillation Ventilation in the Treatment of Paediatric Acute Hypoxaemic Res-piratory Failure -⁠ Analysis of the Years 1994 -⁠ 1998

Overview

Objective:
There were two objectives of the submitted investigation: 1. To demonstrate the effect of highfrequency oscillation on the gas exchange in children with severe respiratory failure (ARDS) where conventionalmechanical ventilation had failed. 2. To attempt identification of patients where failure of high frequencyoscillation is very probable and thus there is a great risk of death.Type of study: Retrospective analysis of a group. Site: ARO and ECMO Centre of the Children™s HospitalBrno.Patients: 26 patients above 1 month of age with severe hypoxaemic respiratory failure and ARDS. Mean age3.66 years (three adults -⁠ 17, 19 and 24 years), maximum body weight 70 kg, 17 boys, 9 girls. Fifteen patients died,84.6% patients suffered from some internal disease, mean PRISM score on admission 22. Nine patients met theECMO criteria, in two ECMO was not necessary, in another five patients ECMO was contraindicated, two patientswere connected with ECMO. To four patients during HFO iNO was administered, in two moreover partial liquidventilation was used.Method: The patients were connected to a PCV or PRVC regime with a limited peak pressure and permissivehypercapnia. If PaCO2 > 10.0 kPa and/or pH 0.6 and Paw > 15 cm H2O for peripheral blood saturation to a minimum of 90% had to be used orin case of persisting hypercapnia and/or acidosis in CMV with TGI the patients were switched to HFO. The HFOstrategy was —High Volume Strategyii -⁠ recruitment of alveoli and achievement of the optimal pulmonary volume.For switching back to CMV the patient had to meet the following criteria: Paw 15 -⁠ 20 cm H2O, FiO2 90%, FiO2

Key words:
high frequency oscillation (HFO), respiratory failure, children, conventional mechanical ventilation