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

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


  • eng

Conference Location

  • United States