Rescue High Frequency Ventilation in Pulmonary Hemorrhage in an Extremely Low Birth Weight Hypothermic Infant

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 444A
Author(s):  
Marta Simon ◽  
Manuela Cucerea ◽  
Zsuzsanna Gall ◽  
Monika Rusneac ◽  
Luminita Zahiu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
High Frequency ◽  
Pulmonary Hemorrhage ◽  
Extremely Low Birth Weight ◽  
High Frequency Ventilation ◽  
Frequency Ventilation

scholarly journals Ventilatory management in extremely low birth weight infants

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Shaun Morris ◽  
Karen Choong
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Extremely Low Birth Weight ◽  
High Frequency Ventilation ◽  
Low Birth Weight Infants ◽  
Ventilator Induced Lung Injury ◽  
Frequency Ventilation

The improvement in survival in premature infants associated with the evolution of mechanical ventilation has been accompanied by an increase in ventilator induced lung injury. High frequency ventilation has been shown to reduce the incidence of ventilator induced lung injury and hence chronic lung disease in the very low birth weight infant. The evolution in understanding how to best use high frequency ventilation in this population has prompted us to ask whether similar strategies to optimize lung volumes on conventional mechanical ventilation can minimize chronic lung disease in the neonate. We retrospectively reviewed the medical charts of 51 extremely low birth weight infants born in Kingston, Ontario in two epochs, 1990 to 1991 and 1999 to 2000, for ventilatory strategy and outcome. From our review, it is clear that surfactant therapy rapidly changes lung mechanics by improving pulmonary compliance and that lung damage may result if there are not changes in the ventilatory management to reflect the altered compliance. Early ventilation strategies during the apparently stable "honeymoon period" in a patient with respiratory distress syndrome (RDS) has significant implications on long term morbidity. In the era prior to the use of surfactant, 30% of infants died and 40% developed chronic lung disease (CLD). Immediately following the use of surfactant, mortality was reduced to 18%, however, the incidence of CLD increased to 78%. In the most recent era, following 10 years of experience with surfactant and mechanical ventilation, morbidity was 17% and CLD 21%. This study demonstrates that a particularly crucial time is in the immediate period following surfactant administration. The use of lower peak inspiratory pressure (PIP) and mean airway pressure (MAP) over the first 24 hours and an increase in the use of synchronous intermittent mandatory ventilation (SIMV) was associated with an improved outcome. The challenge remaining is to determine how to best utilize a conventional mode of ventilation to best optimize lung volume and protect the immature lung.

scholarly journals Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
David Kurahara ◽  
Marina Morie ◽  
Maya Yamane ◽  
Sarah Lam ◽  
Wallace Matthews ◽  
...  
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Lupus Erythematosus ◽  
High Frequency ◽  
Pulmonary Hemorrhage ◽  
High Frequency Ventilation ◽  
First Case ◽  
Pulmonary Hemosiderosis ◽  
Life Saving ◽  
Frequency Ventilation ◽  
History Of

We describe a possible association between pulmonary hemosiderosis (PH) and a history of bronchopulmonary dysplasia (BPD). Both patients were born at 28-week gestation and presented with PH at ages 22 months and 6 years, respectively. Both initially presented with cough and tachypnea, and bronchoalveolar lavage showed evidence of hemosiderin-laden macrophages. Initial hemoglobin levels were < 4 g/dL and chest radiographs showed diffuse infiltrates that cleared dramatically within days after initiation of intravenous corticosteroids. In the first case, frank pulmonary blood was observed upon initial intubation, prompting the need for high frequency ventilation, immediate corticosteroids, and antibiotics. The mechanical ventilation wean was made possible by the addition of mycophenolate mofetil (MMF) and hydroxychloroquine. Slow tapering off of medications was accomplished over 6 years. These cases represent a possible correlation between prematurity-associated BPD and PH. We present a review of the literature regarding this possible association. In addition, MMF proved to be life-saving in one of the PH cases, as it has been in pulmonary hemorrhage related to systemic lupus erythematosus. Further studies are warranted to investigate the possible association between PH and prematurity-related BPD, as well as the use of MMF in the treatment of PH.

scholarly journals Outcome of neonates receiving high frequency oscillation ventilation in a tertiary care institution

2019 ◽  
Vol 6 (3) ◽  
pp. 959
Author(s):  
Kalpana M. S. ◽  
Kalyani S.
Keyword(s):  
Respiratory Failure ◽  
High Frequency ◽  
Tertiary Care ◽  
Pulmonary Hemorrhage ◽  
Oxygenation Index ◽  
Lung Recruitment ◽  
High Frequency Oscillation ◽  
High Frequency Ventilation ◽  
Female Ratio ◽  
Frequency Ventilation

Background: High-frequency ventilation is defined as ventilation at a frequency greater than four times normal respiratory rate. HFOV has been used as alternative to conventional ventilation and in respiratory failure of various etiologies. The aim of the study was to identify the indications of neonates receiving HFOV, following failure of conventional ventilation.Methods: Total 93 neonates were enrolled in the study who received HFOV. The criteria for starting HFOV, the ventilator settings, CBG and ABG analysis, oxygenation index (OI), duration of ventilation and complications of ventilation were recorded during CMV and subsequently when shifted over to HFOV. Outcomes such as oxygenation, lung recruitment and ventilation and survival were monitored.Results: Total 66 neonates (71%) were term babies. Among the 27 preterm 18 (18.4%) were 33-34±6 weeks of gestational age. Male were 50 in number (53.8%) and female were 43 (46.2%). The male: female ratio was 50:43. Disease specific survival analysis revealed more than 50% survival in cases of pneumonia, collapse, air leak, MAS and pulmonary hemorrhage. 16 out of 33 babies (48.5%) with PPHN survived. All 3 babies with CDH expired. Of the 93 neonates included in the study, 53 (57%) of them were discharged home. The major complications noted while on HFOV were- 38 neonates (40.8%) had air leaks. Instead of, ventilator associated pneumonia was present in 42 of them (45.1%) and none of them developed IVH or NTB (Necrotising tracheo bronchitis).Conclusions: HFOV is a safe and effective technique in the treatment of neonates with respiratory failure in whom CMV fails. The results of present study show that rescue HFOV improved oxygenation, ventilation and lung recruitment and there was no increased incidence of IVH.

Management with High Frequency Ventilation of Acute Idiopathic Pulmonary Hemorrhage in Infants

2004 ◽  
Vol 47 (1) ◽  
pp. 132
Author(s):  
Chung Hyun Park ◽  
Wook Jong Kim ◽  
Min Goo Kim ◽  
Min Sung Kim ◽  
Young Jun Hwang ◽  
...  
Keyword(s):  
High Frequency ◽  
Pulmonary Hemorrhage ◽  
High Frequency Ventilation ◽  
Frequency Ventilation
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