Target volume-guarantee in high-frequency oscillatory ventil
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The aim of the study was to define HFOV-VG parameters leading to adequate ventilation in the first 72 h of preterm RDS using a low volume and high-frequency strategy. Respiratory distress syndrome (RDS) and ventilation-induced lung injury lead to significant morbidity in preterm infants. High-frequency oscillatory ventilation with volume-guarantee (HFOV-VG) has been used as a rescue therapy and might lead to lower rates of death and bronchopulmonary dysplasia, especially when using low tidal volumes and high frequencies.

Retrospective cohort study in a tertiary-level neonatology unit. Infants less than 32 weeks with severe respiratory insufficiency needing HFOV-VG were included. Patients were ventilated following a standard mechanical ventilation aiming for low tidal volumes and high frequencies.

Results:
--116 patients were included. Median gestational age was 25 weeks (interquartile range [IQR]=24–27), median birth weight 724g (IQR=600–900 g).

--HFOV-VG was started at 2h, median high-frequency tidal volume was 1.63ml/kg (IQR=1.44–1.84) and median frequency was 16Hz (IQR=15–18).

--Weight-adjusted tidal volumes did not depend on gestational age, antenatal corticosteroids nor chorioamnionitis, and were inversely correlated with frequencies (R2=-0.10).

Finally, when employing enough volumes, HFOV-VG can provide sufficient ventilation at high frequency, thus offering a realistic ventilation approach that can be of assistance in pre-term RDS newborns.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ppul.25529?af=R
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