Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.10/1421
Título: High-frequency oscillatory ventilation in children: a 10-year experience
Autor: Moniz, M
Silvestre, C
Nunes, P
Abadesso, C
Matias, E
Loureiro, H
Almeida, HI
Palavras-chave: High-frequency ventilation
Pediatric intensive care unit
Portugal
Data: 2013
Editora: Sociedade Brasileira de Pediatria
Citação: J Pediatr (Rio J). 2013 Jan-Feb;89(1):48-55
Resumo: OBJECTIVES: The aim of the study was to describe the experience with high-frequency oscillatory ventilation (HFOV) in a Portuguese Pediatric Critical Care Unit, and to evaluate whether HFOV allowed improvement in oxygenation and ventilation. METHODS: This was a retrospective observational cohort study of children ventilated by HFOV between January, 2002 and December, 2011. The following parameters were recorded: demographic and clinical data, and blood gases and ventilatory parameters during the first 48 hours of HFOV. RESULTS: 80 children were included, with a median age of 1.5 months (min: one week; max: 36 months). Pneumonia (n=50; 62.5%) and bronchiolitis (n=18; 22.5%) were the main diagnoses. Approximately 40% (n=32) of the patients developed acute respiratory distress syndrome (ARDS). Conventional mechanical ventilation was used in 68 (85%) of patients prior to HFOV. All patients who started HFOV had hypoxemia, and 56 (70%) also presented persistent hypercapnia. Two hours after starting HFOV, a significant improvement in SatO2/FiO2 ratio (128±0.63 vs. 163±0.72; p<0.001) that was sustained up to 24 hours of HFOV and a decrease in FiO2 were observed. Since the beginning of HFOV, the mean PCO2 significantly decreased (87±33 vs. 66±25; p<0.001), and the pH significantly improved (7.21±0.17 vs. 7.32±0.15; p<0.001). Overall survival was 83.8%. CONCLUSIONS: HFOV enabled an improvement in hypercapnia and oxygenation. It is a safe option for the treatment of ARDS and severe small airway diseases.
Peer review: yes
URI: http://hdl.handle.net/10400.10/1421
DOI: 10.1016/j.jped.2013.02.008.
Versão do Editor: http://www.scielo.br/scielo.php?pid=S0021-75572013000100008&script=sci_arttext&tlng=es
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