The Use of Noninvasive Ventilation with High Frequency in Newborns-A Single-Center Experience

Abstract

Objective: The aim of the study is to evaluate the efficacy of noninvasive high-frequency ventilation (nHFV) in respiratory-deficient infants.

Study design: Retrospective analysis of 32 cases of nHFV in 30 term (n = 4) and preterm (n = 26) newborns using a noninvasive ventilation (NIV) device. nHFV avoided intubation of children performed with NIV and reintubation after long-term mechanical ventilation (MV). Patients were divided into three groups: Group 1: NIV from birth (n = 18, mean birth weight [BW]: 1,987 g, gestational age [GA]: 33.1 weeks); Group 2: MV, also used temporarily, and NIV (n = 10, BW: 1,074 g, GA: 28.2 weeks); and Group 3: two cases with nHFV avoided reintubation after long-term MV (BW: 725 g, GA: 24.5 weeks).

Results: From 32 episodes of nHFV application, positive effect was achieved 26 times (81%) (24 of 30 children). All newborns had a significant increase in pH (7.23-7.27) and reduction in partial pressure of CO₂ (66.7-58.9 mm Hg, over 1-2 hours). Failures in application of nHFV reported only in Group 1 (6/18, 33%) (failures primarily due to increasing demand for oxygen). There were two reports of pneumothorax in preterm infants with congenital pneumonia. No other nHFV-related complications were noted.

Conclusion: nHFV is a promising NIV mode which can be also used with NIV devices.