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5 results

  • Patent ductus arteriosus ligation under high-frequency oscillatory ventilation in two critically ill pre-mature newborns

  • Turkay Rzayev, Yakup Karakurt, Murat Ugurlucan, Ayhan Tastekin, Gamze Demirel
  • Journal:
    Cardiology in the Young / Volume 33 / Issue 4 / April 2023
    Published online by Cambridge University Press:
    30 August 2022, pp. 669-671
    • Article
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  • Information on the use of high-frequency oscillatory ventilation in neonatal surgeries is very rare. In this report, we discuss two pre-term infants who had to receive high-frequency oscillatory ventilation as a rescue treatment due to severe pre-maturity. These two cases underwent successful bedside patent ductus arteriosus ligation under high-frequency oscillatory ventilation, and this shows us that patent ductus arteriosus ligation can be performed successfully in neonates even under high-frequency oscillatory ventilation.

  • Rescue high-frequency oscillatory ventilation combined with intermittent mandatory ventilation for infants with acute respiratory distress syndrome after congenital heart surgery

  • Yi-Rong Zheng, Shi-Hao Lin, Yu-Kun Chen, Hua Cao, Qiang Chen
  • Journal:
    Cardiology in the Young / Volume 33 / Issue 7 / July 2023
    Published online by Cambridge University Press:
    01 August 2022, pp. 1165-1171
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  • Background:

    This study aimed to evaluate the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation in infants with acute respiratory distress syndrome after congenital heart surgery.

    Methods:

    We retrospectively analysed the clinical data of 32 infants who were ventilated due to acute respiratory distress syndrome after congenital heart surgery between January, 2020 and January, 2022. We adopted high-frequency oscillation ventilation combined with intermittent mandatory ventilation as the rescue ventilation mode for infants who were failing conventional mechanical ventilation.

    Results:

    After rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation, the dynamic compliance (Cdyn), PaO2 and PaO2/FiO2 ratio of the infants improved compared with conventional mechanical ventilation (p < 0.05). Moreover, high-frequency oscillation ventilation combined with intermittent mandatory ventilation resulted in a significant decrease in arterial-alveolar oxygen difference (AaDO2), FiO2, and oxygenation index (p < 0.05). No significant effect on haemodynamic parameters was observed. Moreover, no serious complications occurred in the two groups.

    Conclusion:

    Rescue high-frequency oscillation ventilation combined with intermittent mandatory ventilation significantly improved oxygenation in infants who failed conventional mechanical ventilation for acute respiratory distress syndrome after congenital heart surgery. Thus, this strategy is considered safe and feasible. However, further studies must be conducted to confirm the efficacy and safety of high-frequency oscillation ventilation combined with intermittent mandatory ventilation as a rescue perioperative respiratory support strategy for CHD.

  • 9.4 - Respiratory Failure

  • from Section 9 - Paediatric Care
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 698-702

  • Summary

    Key Learning Points

    1. 1. The anatomy and physiology of young children make them particularly vulnerable to respiratory failure.

    2. 2. Children who need intubating for upper airway obstruction require input from doctors competent in the management of the paediatric airway.

    3. 3. Respiratory failure is the most common indication for admission to the paediatric intensive care unit.

    4. 4. The principles of lung-protective ventilation apply in children.

    5. 5. High-frequency oscillatory ventilation is an effective rescue modality in children.

  • Chapter 43 - Trauma and burns

  • from Section III: - Organ dysfunction and management
  • Edited by Fang Gao Smith, University of Warwick
  • Edited in association with Joyce Yeung
  • Book:
    Core Topics in Critical Care Medicine
    Published online:
    06 July 2010
    Print publication:
    22 April 2010, pp 334-341

  • Summary

    A range of interventions has been devised to try to extend the potential range for conventional ventilation, as well as alternative strategies to support patients with respiratory failure beyond the current limits of conventional ventilation. Given that in the majority of patients acute respiratory distress syndrome (ARDS) is reversible, placing the patient in the prone position during conventional ventilation can improve oxygenation failure in this setting. Recruitment manoeuvres (RMs) are used to improve the volume of aerated lung, and consequently hypoxaemia, principally in patients receiving conventional ventilation for ARDS. In adult practice in the UK, high-frequency oscillation (HFOV) is generally used as a rescue for ARDS patients with refractory hypoxaemia on conventional ventilation. Extracorporeal CO2 removal potentially offers a rescue intervention in patients with severe hypercarbic respiratory failure. Transtracheal gas insufflation (TGI) appears a promising complementary technique to mechanical ventilation.

  • 6 - Oxygenation

  • Edited by Iain Mackenzie
  • Book:
    Core Topics in Mechanical Ventilation
    Published online:
    14 October 2009
    Print publication:
    30 October 2008, pp 115-141

  • Summary

    Oxygenation is one of the primary gas exchange functions of the lung. This chapter reviews how to assess the adequacy of oxygen uptake and, in the context of the mechanisms of arterial hypoxaemia, examines how this can be improved in the mechanically ventilated patient. The oxygenation assessment has two facets, one pulmonary, and one extra-pulmonary. Oxygen moves from the alveolar gas to the pulmonary capillary blood by diffusion. Currently in the UK, as with high-frequency oscillatory ventilation (HFOV), airway pressure release ventilation (APRV) is typically used as a rescue technique for those failing to achieve adequate oxygenation with conventional ventilation. The diffusion coefficient for a gas is proportional to the gas's solubility in the medium through which the gas has to diffuse, and is inversely proportional to the square root of the gas's relative molecular mass. Imbalance between pulmonary ventilation and pulmonary perfusion is the most common cause of hypoxaemia.