Abstract
Background: Short-term high-frequency nasal ventilation (HFNV) of preterm neonates provides acceptable gas exchange compared to endotracheal intubation and intermittent mandatory ventilation (IMV). Whether long-term HFNV will provide acceptable gas exchange is unknown. We hypothesized that HFNV for up to 21 d would lead to acceptable gas exchange at lower inspired oxygen (O 2) levels and airway pressures compared to intubation and IMV. Methods: Preterm lambs were exposed to antenatal steroids and treated with perinatal surfactant and postnatal caffeine. Lambs were intubated and resuscitated by IMV. At ∼3 h of age, half of the lambs were switched to noninvasive HFNV. Support was for 3 or 21 d. By design, Pao2 and Paco2 were not different between groups. Results: At 3 d (n = 5) and 21 d (n = 4) of HFNV, fractional inspired O2 (FiO 2), peak inspiratory pressure (PIP), mean airway, intratracheal, and positive end-expiratory pressures, oxygenation index, and alveolar-arterial gradient were significantly lower than matched periods of intubation and IMV. Pao2/FiO2 ratio was significantly higher at 3 and 21 d of HFNV compared to matched intubation and IMV. HFNV led to better alveolarization at 3 and 21 d. Conclusion: Long-term HFNV provides acceptable gas exchange at lower inspired O2 levels and respiratory pressures compared to intubation and IMV.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 507-516 |
| Number of pages | 10 |
| Journal | Pediatric Research |
| Volume | 75 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 1 2014 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs. / Null, Donald; Alvord, Jeremy; Leavitt, Wendy; Wint, Albert; Dahl, Mar Janna; Presson, Angela P.; Lane, Robert H.; Digeronimo, Robert J.; Yoder, Bradley A.; Albertine, Kurt H.
In: Pediatric Research, Vol. 75, No. 4, 01.01.2014, p. 507-516.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs
AU - Null, Donald
AU - Alvord, Jeremy
AU - Leavitt, Wendy
AU - Wint, Albert
AU - Dahl, Mar Janna
AU - Presson, Angela P.
AU - Lane, Robert H.
AU - Digeronimo, Robert J.
AU - Yoder, Bradley A.
AU - Albertine, Kurt H.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Background: Short-term high-frequency nasal ventilation (HFNV) of preterm neonates provides acceptable gas exchange compared to endotracheal intubation and intermittent mandatory ventilation (IMV). Whether long-term HFNV will provide acceptable gas exchange is unknown. We hypothesized that HFNV for up to 21 d would lead to acceptable gas exchange at lower inspired oxygen (O 2) levels and airway pressures compared to intubation and IMV. Methods: Preterm lambs were exposed to antenatal steroids and treated with perinatal surfactant and postnatal caffeine. Lambs were intubated and resuscitated by IMV. At ∼3 h of age, half of the lambs were switched to noninvasive HFNV. Support was for 3 or 21 d. By design, Pao2 and Paco2 were not different between groups. Results: At 3 d (n = 5) and 21 d (n = 4) of HFNV, fractional inspired O2 (FiO 2), peak inspiratory pressure (PIP), mean airway, intratracheal, and positive end-expiratory pressures, oxygenation index, and alveolar-arterial gradient were significantly lower than matched periods of intubation and IMV. Pao2/FiO2 ratio was significantly higher at 3 and 21 d of HFNV compared to matched intubation and IMV. HFNV led to better alveolarization at 3 and 21 d. Conclusion: Long-term HFNV provides acceptable gas exchange at lower inspired O2 levels and respiratory pressures compared to intubation and IMV.
AB - Background: Short-term high-frequency nasal ventilation (HFNV) of preterm neonates provides acceptable gas exchange compared to endotracheal intubation and intermittent mandatory ventilation (IMV). Whether long-term HFNV will provide acceptable gas exchange is unknown. We hypothesized that HFNV for up to 21 d would lead to acceptable gas exchange at lower inspired oxygen (O 2) levels and airway pressures compared to intubation and IMV. Methods: Preterm lambs were exposed to antenatal steroids and treated with perinatal surfactant and postnatal caffeine. Lambs were intubated and resuscitated by IMV. At ∼3 h of age, half of the lambs were switched to noninvasive HFNV. Support was for 3 or 21 d. By design, Pao2 and Paco2 were not different between groups. Results: At 3 d (n = 5) and 21 d (n = 4) of HFNV, fractional inspired O2 (FiO 2), peak inspiratory pressure (PIP), mean airway, intratracheal, and positive end-expiratory pressures, oxygenation index, and alveolar-arterial gradient were significantly lower than matched periods of intubation and IMV. Pao2/FiO2 ratio was significantly higher at 3 and 21 d of HFNV compared to matched intubation and IMV. HFNV led to better alveolarization at 3 and 21 d. Conclusion: Long-term HFNV provides acceptable gas exchange at lower inspired O2 levels and respiratory pressures compared to intubation and IMV.
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U2 - 10.1038/pr.2013.254
DO - 10.1038/pr.2013.254
M3 - Article
VL - 75
SP - 507
EP - 516
JO - Pediatric Research
JF - Pediatric Research
SN - 0031-3998
IS - 4
ER -