Randomized trial of high-frequency oscillatory ventilation versus conventional ventilation: effect on systemic blood flow in very preterm infants - 29/08/11
, Nick Evans, MRCPCH, DM
Reprint requests: David Osborn, MM, FRACP, RPA Newborn Care, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW, Australia 2050.Abstract |
Objective Low superior vena cava (SVC) flow is common in very preterm infants in the first day and strongly associated with periventricular hemorrhage and disability. We examined the effect of high-frequency oscillatory ventilation (HFOV) compared with conventional ventilation (CV) on SVC flow and right ventricular output.
Methods Forty-five infants <29 weeks were randomized before 1 hour of age to HFOV or CV. Echocardiography was performed on 43 infants at 3, 10, and 24 hours of age. Infants with low SVC flow (<50 mL/kg/min) or hypotension (mean blood pressure ≤20) were treated with volume and inotrope.
Results Infants allocated to HFOV (n=23) and to CV (n=20) were well matched. There was a nonsignificant trend toward more infants on HFOV having SVC flow <50 mL/kg/min (48% vs 20%) and receiving volume and inotropes (61% vs 40%). There were no significant differences in mean SVC flow or right ventricular output at 3, 10, or 24 hours. Infants on HFOV had a significantly higher calculated upper body vascular resistance at 10 hours and mean blood pressure at 24 hours.
Conclusions There were no significant adverse effects of HFOV on systemic blood flow in very preterm infants during the first 24 hours of life.
Le texte complet de cet article est disponible en PDF.Abbreviations : BP, CV, DA, Fio2, HFOV, MAP, Paco2, PVH, RVO, SVC, UBVR, UKOS
Plan
Vol 143 - N° 2
P. 192-198 - août 2003 Retour au numéro
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