Lung recruitment in neonatal high‐frequency oscillatory ventilation with volume‐guarantee
Background and Objectives The optimal lung volume strategy during high‐frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) assoc...
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| Veröffentlicht in: | Pediatric pulmonology 2022-12, Vol.57 (12), p.3000-3008 |
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| creator | Solis‐Garcia, Gonzalo González‐Pacheco, Noelia Ramos‐Navarro, Cristina Vigil‐Vázquez, Sara Gutiérrez‐Vélez, Ana Merino‐Hernández, Amaia Rodríguez Sánchez De la Blanca, Ana Sánchez‐Luna, Manuel |
| description | Background and Objectives
The optimal lung volume strategy during high‐frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) associated with a progressive increase in mean airway pressure during HFOV combined with volume guarantee (HFOV‐VG) identifies optimal lung recruitment. The aim of this study was to describe recruitment maneuvers in HFOV‐VG and analyze whether changes in ΔPhf might be an early predictor for lung recruitment in newborn infants with severe respiratory failure.
Design and Methods
The prospective observational study was done in a tertiary‐level neonatology department. Changes in ΔPhf were analyzed during standardized lung recruitment after initiating early rescue HFOV‐VG in preterm infants with severe respiratory failure.
Results
Twenty‐seven patients were included, with a median gestational age of 24 weeks (interquartile range [IQR]: 23–25). Recruitment maneuvers were performed, median baseline mean airway pressure (mPaw) was 11 cm H2O (IQR: 10–13), median critical lung opening mPaw during recruitment was 14 cm H2O (IRQ: 12–16), and median optimal mPaw was 12 cm H2O (IQR: 10–14, p |
| doi_str_mv | 10.1002/ppul.26124 |
| format | Article |
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The optimal lung volume strategy during high‐frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) associated with a progressive increase in mean airway pressure during HFOV combined with volume guarantee (HFOV‐VG) identifies optimal lung recruitment. The aim of this study was to describe recruitment maneuvers in HFOV‐VG and analyze whether changes in ΔPhf might be an early predictor for lung recruitment in newborn infants with severe respiratory failure.
Design and Methods
The prospective observational study was done in a tertiary‐level neonatology department. Changes in ΔPhf were analyzed during standardized lung recruitment after initiating early rescue HFOV‐VG in preterm infants with severe respiratory failure.
Results
Twenty‐seven patients were included, with a median gestational age of 24 weeks (interquartile range [IQR]: 23–25). Recruitment maneuvers were performed, median baseline mean airway pressure (mPaw) was 11 cm H2O (IQR: 10–13), median critical lung opening mPaw during recruitment was 14 cm H2O (IRQ: 12–16), and median optimal mPaw was 12 cm H2O (IQR: 10–14, p < 0.01). Recruitment maneuvers were associated with an improvement in oxygenation (FiO2: 65.0 vs. 45.0, p < 0.01, SpO2/FiO2 ratio: 117 vs. 217, p < 0.01). ΔPhf decreased significantly after lung recruitment (mean amplitude: 23.0 vs. 16.0, p < 0.01).
Conclusion
In preterm infants with severe respiratory failure, the lung recruitment process can be effectively guided by ΔPhf on HFOV‐VG.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.26124</identifier><identifier>PMID: 35996817</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Animals ; bronchopulmonary dysplasia ; High-Frequency Ventilation ; high‐frequency oscillatory ventilation ; Humans ; Infant, Newborn ; Infant, Premature ; Intermittent Positive-Pressure Ventilation ; Lung ; neonatal respiratory distress syndrome ; Newborn babies ; open lung ; Premature babies ; recruitment maneuver ; Respiratory Distress Syndrome, Newborn - therapy ; Respiratory failure ; Respiratory Insufficiency - therapy ; Ventilators ; volume‐guarantee</subject><ispartof>Pediatric pulmonology, 2022-12, Vol.57 (12), p.3000-3008</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3574-ca18a0790393979064b29b61240d110a6f9e549aa158a44e5a4e079d6bde280d3</citedby><cites>FETCH-LOGICAL-c3574-ca18a0790393979064b29b61240d110a6f9e549aa158a44e5a4e079d6bde280d3</cites><orcidid>0000-0002-7966-260X ; 0000-0002-5121-8291 ; 0000-0001-9543-7392 ; 0000-0002-1293-6979 ; 0000-0003-2256-8572 ; 0000-0002-6693-6405 ; 0000-0002-5654-0642</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.26124$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.26124$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35996817$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Solis‐Garcia, Gonzalo</creatorcontrib><creatorcontrib>González‐Pacheco, Noelia</creatorcontrib><creatorcontrib>Ramos‐Navarro, Cristina</creatorcontrib><creatorcontrib>Vigil‐Vázquez, Sara</creatorcontrib><creatorcontrib>Gutiérrez‐Vélez, Ana</creatorcontrib><creatorcontrib>Merino‐Hernández, Amaia</creatorcontrib><creatorcontrib>Rodríguez Sánchez De la Blanca, Ana</creatorcontrib><creatorcontrib>Sánchez‐Luna, Manuel</creatorcontrib><title>Lung recruitment in neonatal high‐frequency oscillatory ventilation with volume‐guarantee</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>Background and Objectives
The optimal lung volume strategy during high‐frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) associated with a progressive increase in mean airway pressure during HFOV combined with volume guarantee (HFOV‐VG) identifies optimal lung recruitment. The aim of this study was to describe recruitment maneuvers in HFOV‐VG and analyze whether changes in ΔPhf might be an early predictor for lung recruitment in newborn infants with severe respiratory failure.
Design and Methods
The prospective observational study was done in a tertiary‐level neonatology department. Changes in ΔPhf were analyzed during standardized lung recruitment after initiating early rescue HFOV‐VG in preterm infants with severe respiratory failure.
Results
Twenty‐seven patients were included, with a median gestational age of 24 weeks (interquartile range [IQR]: 23–25). Recruitment maneuvers were performed, median baseline mean airway pressure (mPaw) was 11 cm H2O (IQR: 10–13), median critical lung opening mPaw during recruitment was 14 cm H2O (IRQ: 12–16), and median optimal mPaw was 12 cm H2O (IQR: 10–14, p < 0.01). Recruitment maneuvers were associated with an improvement in oxygenation (FiO2: 65.0 vs. 45.0, p < 0.01, SpO2/FiO2 ratio: 117 vs. 217, p < 0.01). ΔPhf decreased significantly after lung recruitment (mean amplitude: 23.0 vs. 16.0, p < 0.01).
Conclusion
In preterm infants with severe respiratory failure, the lung recruitment process can be effectively guided by ΔPhf on HFOV‐VG.</description><subject>Animals</subject><subject>bronchopulmonary dysplasia</subject><subject>High-Frequency Ventilation</subject><subject>high‐frequency oscillatory ventilation</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Intermittent Positive-Pressure Ventilation</subject><subject>Lung</subject><subject>neonatal respiratory distress syndrome</subject><subject>Newborn babies</subject><subject>open lung</subject><subject>Premature babies</subject><subject>recruitment maneuver</subject><subject>Respiratory Distress Syndrome, Newborn - therapy</subject><subject>Respiratory failure</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Ventilators</subject><subject>volume‐guarantee</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90E9LwzAYBvAgipvTix9ACl5E6EyaJm2OMvwHA3dwRylZ-3bLaNOaNBu7-RH8jH4SMzc9ePD0BvLj4X0fhM4JHhKMo5u2ddUw4iSKD1CfYCFCHAt-iPppwljIU0576MTaJcb-T5Bj1KNMCJ6SpI9ex07PAwO5caqrQXeB0oGGRstOVsFCzRef7x-lgTcHOt8Ejc1VVcmuMZtg5bXyb9XoYK26RbBqKleD93MnjdQdwCk6KmVl4Ww_B2h6f_cyegzHzw9Po9txmFOWxGEuSSpxIjAVVPjB41kkZtuDcEEIlrwUwGIhJWGpjGNgMgbPCz4rIEpxQQfoapfbmsZvarusVjYHv6k_xdksSjBLGGaUeXr5hy4bZ7TfziuaUI5FRLy63qncNNYaKLPWqFqaTUZwti0925aefZfu8cU-0s1qKH7pT8sekB1Yqwo2_0Rlk8l0vAv9ApADjyg</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Solis‐Garcia, Gonzalo</creator><creator>González‐Pacheco, Noelia</creator><creator>Ramos‐Navarro, Cristina</creator><creator>Vigil‐Vázquez, Sara</creator><creator>Gutiérrez‐Vélez, Ana</creator><creator>Merino‐Hernández, Amaia</creator><creator>Rodríguez Sánchez De la Blanca, Ana</creator><creator>Sánchez‐Luna, Manuel</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7966-260X</orcidid><orcidid>https://orcid.org/0000-0002-5121-8291</orcidid><orcidid>https://orcid.org/0000-0001-9543-7392</orcidid><orcidid>https://orcid.org/0000-0002-1293-6979</orcidid><orcidid>https://orcid.org/0000-0003-2256-8572</orcidid><orcidid>https://orcid.org/0000-0002-6693-6405</orcidid><orcidid>https://orcid.org/0000-0002-5654-0642</orcidid></search><sort><creationdate>202212</creationdate><title>Lung recruitment in neonatal high‐frequency oscillatory ventilation with volume‐guarantee</title><author>Solis‐Garcia, Gonzalo ; González‐Pacheco, Noelia ; Ramos‐Navarro, Cristina ; Vigil‐Vázquez, Sara ; Gutiérrez‐Vélez, Ana ; Merino‐Hernández, Amaia ; Rodríguez Sánchez De la Blanca, Ana ; Sánchez‐Luna, Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3574-ca18a0790393979064b29b61240d110a6f9e549aa158a44e5a4e079d6bde280d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Animals</topic><topic>bronchopulmonary dysplasia</topic><topic>High-Frequency Ventilation</topic><topic>high‐frequency oscillatory ventilation</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Intermittent Positive-Pressure Ventilation</topic><topic>Lung</topic><topic>neonatal respiratory distress syndrome</topic><topic>Newborn babies</topic><topic>open lung</topic><topic>Premature babies</topic><topic>recruitment maneuver</topic><topic>Respiratory Distress Syndrome, Newborn - therapy</topic><topic>Respiratory failure</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Ventilators</topic><topic>volume‐guarantee</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Solis‐Garcia, Gonzalo</creatorcontrib><creatorcontrib>González‐Pacheco, Noelia</creatorcontrib><creatorcontrib>Ramos‐Navarro, Cristina</creatorcontrib><creatorcontrib>Vigil‐Vázquez, Sara</creatorcontrib><creatorcontrib>Gutiérrez‐Vélez, Ana</creatorcontrib><creatorcontrib>Merino‐Hernández, Amaia</creatorcontrib><creatorcontrib>Rodríguez Sánchez De la Blanca, Ana</creatorcontrib><creatorcontrib>Sánchez‐Luna, Manuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Solis‐Garcia, Gonzalo</au><au>González‐Pacheco, Noelia</au><au>Ramos‐Navarro, Cristina</au><au>Vigil‐Vázquez, Sara</au><au>Gutiérrez‐Vélez, Ana</au><au>Merino‐Hernández, Amaia</au><au>Rodríguez Sánchez De la Blanca, Ana</au><au>Sánchez‐Luna, Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung recruitment in neonatal high‐frequency oscillatory ventilation with volume‐guarantee</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2022-12</date><risdate>2022</risdate><volume>57</volume><issue>12</issue><spage>3000</spage><epage>3008</epage><pages>3000-3008</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>Background and Objectives
The optimal lung volume strategy during high‐frequency oscillatory ventilation (HFOV) is reached by performing recruitment maneuvers, usually guided by the response in oxygenation. In animal models, secondary spontaneous change in oscillation pressure amplitude (ΔPhf) associated with a progressive increase in mean airway pressure during HFOV combined with volume guarantee (HFOV‐VG) identifies optimal lung recruitment. The aim of this study was to describe recruitment maneuvers in HFOV‐VG and analyze whether changes in ΔPhf might be an early predictor for lung recruitment in newborn infants with severe respiratory failure.
Design and Methods
The prospective observational study was done in a tertiary‐level neonatology department. Changes in ΔPhf were analyzed during standardized lung recruitment after initiating early rescue HFOV‐VG in preterm infants with severe respiratory failure.
Results
Twenty‐seven patients were included, with a median gestational age of 24 weeks (interquartile range [IQR]: 23–25). Recruitment maneuvers were performed, median baseline mean airway pressure (mPaw) was 11 cm H2O (IQR: 10–13), median critical lung opening mPaw during recruitment was 14 cm H2O (IRQ: 12–16), and median optimal mPaw was 12 cm H2O (IQR: 10–14, p < 0.01). Recruitment maneuvers were associated with an improvement in oxygenation (FiO2: 65.0 vs. 45.0, p < 0.01, SpO2/FiO2 ratio: 117 vs. 217, p < 0.01). ΔPhf decreased significantly after lung recruitment (mean amplitude: 23.0 vs. 16.0, p < 0.01).
Conclusion
In preterm infants with severe respiratory failure, the lung recruitment process can be effectively guided by ΔPhf on HFOV‐VG.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35996817</pmid><doi>10.1002/ppul.26124</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7966-260X</orcidid><orcidid>https://orcid.org/0000-0002-5121-8291</orcidid><orcidid>https://orcid.org/0000-0001-9543-7392</orcidid><orcidid>https://orcid.org/0000-0002-1293-6979</orcidid><orcidid>https://orcid.org/0000-0003-2256-8572</orcidid><orcidid>https://orcid.org/0000-0002-6693-6405</orcidid><orcidid>https://orcid.org/0000-0002-5654-0642</orcidid></addata></record> |
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| subjects | Animals bronchopulmonary dysplasia High-Frequency Ventilation high‐frequency oscillatory ventilation Humans Infant, Newborn Infant, Premature Intermittent Positive-Pressure Ventilation Lung neonatal respiratory distress syndrome Newborn babies open lung Premature babies recruitment maneuver Respiratory Distress Syndrome, Newborn - therapy Respiratory failure Respiratory Insufficiency - therapy Ventilators volume‐guarantee |
| title | Lung recruitment in neonatal high‐frequency oscillatory ventilation with volume‐guarantee |
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