Am J Perinatol 2015; 32(02): 171-176
DOI: 10.1055/s-0034-1381317
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of Noninvasive High-Frequency Ventilation in the Neonatal Intensive Care Unit: A Retrospective Review

Amit Mukerji
1   Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
,
Balpreet Singh
2   Department of Paediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
,
Salhab el Helou
2   Department of Paediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
,
Christoph Fusch
2   Department of Paediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada
,
Michael Dunn
3   Department of Paediatrics, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
,
Jaques Belik
1   Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
,
Vibhuti Shah
4   Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

24 November 2013

21 April 2014

Publication Date:
10 June 2014 (online)

Abstract

Objective The aim of the article is to review the effectiveness of neonatal noninvasive high-frequency ventilation (NIHFV) in preventing endotracheal mechanical ventilation.

Study Design Retrospective case series including all 79 instances of NIHFV use at four participating centers between July 2010 and September 2012.

Results In 73% of cases, NIHFV was used as rescue after another noninvasive mode, and prophylactically (postextubation) in the remainder. In 58% of cases, infants transitioned to another noninvasive mode, without requiring intubation. There were significant reductions in the mean (SD) number of apneas, bradycardias, or desaturations (over 6 hours) (3.2 [0.4] vs. 1.2 [0.3]; p < 0.001), FiO2 (48 [3] vs. 40 [2]%; p < 0.001) and CO2 levels (74 [6] vs. 62 [4] mm Hg; p = 0.025] with NIHFV. No NIHFV-related complications were noted.

Conclusions NIHFV is a promising NIV mode that may help prevent or delay intubation and deserves further clinical research.

 
  • References

  • 1 Donn SM, Sinha SK. Minimising ventilator induced lung injury in preterm infants. Arch Dis Child Fetal Neonatal Ed 2006; 91 (3) F226-F230
  • 2 Hart SM, McNair M, Gamsu HR, Price JF. Pulmonary interstitial emphysema in very low birthweight infants. Arch Dis Child 1983; 58 (8) 612-615
  • 3 Fan E, Villar J, Slutsky AS. Novel approaches to minimize ventilator-induced lung injury. BMC Med 2013; 11: 85
  • 4 Owen LS, Morley CJ, Davis PG. Neonatal nasal intermittent positive pressure ventilation: a survey of practice in England. Arch Dis Child Fetal Neonatal Ed 2008; 93 (2) F148-F150
  • 5 Mahmoud RA, Roehr CC, Schmalisch G. Current methods of non-invasive ventilatory support for neonates. Paediatr Respir Rev 2011; 12 (3) 196-205
  • 6 Roberts CL, Badgery-Parker T, Algert CS, Bowen JR, Nassar N. Trends in use of neonatal CPAP: a population-based study. BMC Pediatr 2011; 11: 89
  • 7 Morley CJ, Davis PG, Doyle LW, Brion LP, Hascoet JM, Carlin JB ; COIN Trial Investigators. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med 2008; 358 (7) 700-708
  • 8 Finer NN, Carlo WA, Walsh MC , et al; SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med 2010; 362 (21) 1970-1979
  • 9 Barrington KJ, Bull D, Finer NN. Randomized trial of nasal synchronized intermittent mandatory ventilation compared with continuous positive airway pressure after extubation of very low birth weight infants. Pediatrics 2001; 107 (4) 638-641
  • 10 De Paoli AG, Davis PG, Lemyre B. Nasal continuous positive airway pressure versus nasal intermittent positive pressure ventilation for preterm neonates: a systematic review and meta-analysis. Acta Paediatr 2003; 92 (1) 70-75
  • 11 Davis PG, Morley CJ, Owen LS. Non-invasive respiratory support of preterm neonates with respiratory distress: continuous positive airway pressure and nasal intermittent positive pressure ventilation. Semin Fetal Neonatal Med 2009; 14 (1) 14-20
  • 12 O'Brien K, Campbell C, Brown L, Wenger L, Shah V. Infant flow biphasic nasal continuous positive airway pressure (BP- NCPAP) vs. infant flow NCPAP for the facilitation of extubation in infants' ≤ 1,250 grams: a randomized controlled trial. BMC Pediatr 2012; 12: 43
  • 13 Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS ; NIPPV Study Group. A trial comparing noninvasive ventilation strategies in preterm infants. N Engl J Med 2013; 369 (7) 611-620
  • 14 Stefanescu BM, Murphy WP, Hansell BJ, Fuloria M, Morgan TM, Aschner JL. A randomized, controlled trial comparing two different continuous positive airway pressure systems for the successful extubation of extremely low birth weight infants. Pediatrics 2003; 112 (5) 1031-1038
  • 15 van der Hoeven M, Brouwer E, Blanco CE. Nasal high frequency ventilation in neonates with moderate respiratory insufficiency. Arch Dis Child Fetal Neonatal Ed 1998; 79 (1) F61-F63
  • 16 Colaizy TT, Younis UM, Bell EF, Klein JM. Nasal high-frequency ventilation for premature infants. Acta Paediatr 2008; 97 (11) 1518-1522
  • 17 Dumas De La Roque E, Bertrand C, Tandonnet O , et al. Nasal high frequency percussive ventilation versus nasal continuous positive airway pressure in transient tachypnea of the newborn: a pilot randomized controlled trial. Pediatr Pulmonol 2011; 46: 218-222
  • 18 Czernik C, Schmalisch G, Bührer C, Proquitté H. Weaning of neonates from mechanical ventilation by use of nasopharyngeal high-frequency oscillatory ventilation: a preliminary study. J Matern Fetal Neonatal Med 2012; 25 (4) 374-378
  • 19 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978; 92 (4) 529-534
  • 20 Courtney SE, Durand DJ, Asselin JM, Hudak ML, Aschner JL, Shoemaker CT ; Neonatal Ventilation Study Group. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants. N Engl J Med 2002; 347 (9) 643-652
  • 21 Johnson AH, Peacock JL, Greenough A , et al; United Kingdom Oscillation Study Group. High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity. N Engl J Med 2002; 347 (9) 633-642