Preliminary observations of the use of high-frequency jet ventilation as rescue therapy in infants with congenital diaphragmatic hernia.
Journal Article (Clinical Trial;Journal Article)
BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is associated with mortality of 10% to 50%. Several investigators have reported outcomes from centers using high-frequency oscillatory ventilation in their management of CDH, but there are no recent reports on use of high-frequency jet ventilation. METHODS: During the study period from January 2001 until August 2007, infants with CDH who were cared for at Duke University Medical Center received high-frequency jet ventilation as a rescue mode of high-frequency ventilation. We compared actual survival with predicted survival for infants treated only with conventional ventilation vs those rescued with high-frequency jet ventilation after failing conventional ventilation. RESULTS: Survival for the 16 infants that received high-frequency jet ventilation was predicted to be 63%; actual survival was 75%. Survival for the 15 infants that received only conventional ventilation was predicted to be 83%; actual survival was 87%. We observed no significant survival benefit for high-frequency jet ventilation, 8.0% (95 confidence interval, -22.0% to 38.1%; P = .59). CONCLUSIONS: Although our sample size was small, we conclude with consideration of the absolute results, the degree of illness of the infants, and the biologic plausibility for the intervention that high-frequency jet ventilation is an acceptable rescue ventilation mode for infants with CDH.
Full Text
Duke Authors
- Cotten, Charles Michael
- Goldberg, Ronald Norman
- Rice, Henry Elliot
- Smith, Phillip Brian
- Tracy, Elisabeth Tomlinson
Cited Authors
- Kuluz, MA; Smith, PB; Mears, SP; Benjamin, JR; Tracy, ET; Williford, WL; Goldberg, RN; Rice, HE; Cotten, CM
Published Date
- April 2010
Published In
Volume / Issue
- 45 / 4
Start / End Page
- 698 - 702
PubMed ID
- 20385273
Pubmed Central ID
- PMC3243761
Electronic International Standard Serial Number (EISSN)
- 1531-5037
Digital Object Identifier (DOI)
- 10.1016/j.jpedsurg.2009.07.025
Language
- eng
Conference Location
- United States