2003 OPEN FORUM Abstracts
HIGH FREQUENCY PERCUSSIVE VENTILATION IN PREMATURE INFANTS
WITH RESPIRATORY DISTRESS SYNDROME: RANDOMISED TRIAL
AND 14 YEARS OF EXPERIENCE
Adel Bougatef1, MD, Luc Foubert2, MD, PhD, Ann Casteels1, MD, Filip Cools1, MD, Daniël De Wolf3, MD, PhD. 1NICU, Academic Hospital, Free University Brussels; 2Department of Anaesthesia and Intensive Care, OLV Hospital Aalst; 3Department of Paediatric Cardiology,Ghent University Hospital; Belgium.
We evaluated the safety and efficacy of high frequency percussive ventilation as a ventilation mode in premature infants (gestational age ≤ 32 weeks) with respiratory distress syndrome. In a first study a prospective randomized trial was conducted to compare the effects of high frequency percussive ventilation with conventional ventilation in neonates (n = 52) from 1986 to 1989. This study was followed by a retrospective analysis (from 1989 to 1998) of 273 consecutive neonates exclusively ventilated with high frequency percussive ventilation. In the third part of the study (from 1998 to 2000) 55 infants on high frequency percussive ventilation, of whom 22 treated with surfactant as rescue therapy, were retrospectively studied. In part 1, the high frequency percussive ventilation group had a lower incidence of pulmonary air leak (8% vs 33%, p<0.05), intraventricular hemorrhage (8% vs 37%, p=0.02) and chronic lung disease assessed at 28 days (15 vs 43 %, NS) and 36 weeks gestational age (0% vs 29%, p<0.02), than the CV group. Mortality was also lower in the high frequency percussive ventilation group (20 vs 48 %, p<0.04). Survival rate in part 2 and 3 of the study was 85 and 89 % respectively, with an identical incidence in air leak (9%). The incidence of intraventricular hemorrhage (12 vs 9 %) and chronic lung disease at 36 weeks gestational age (3 vs. 4 %) was similar in both groups. We conclude that high frequency percussive ventilation is a safe and effective ventilation technique, and results in a favorable pulmonary outcome in preterm infants with respiratory distress syndrome.