High frequency jet ventilation in preterm infants: experience from Western Australia

Anvekar, Ajay; Shah, Piyush; Nathan, Elizabeth; Doherty, Dorota A.; Patole, Sanjay; Simmer, Karen

doi:10.1080/14767058.2018.1449827

Cited by 6 publications

(8 citation statements)

References 8 publications

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“…The sample size (n ¼ 53) is somewhat small; however, HFJV represents a niche area of research, and most modern studies are only able to practically enroll a limited number of subjects. 36,47,48 All subjects were outborn, which has been associated with poorer survival and a higher rate of morbidities including necrotizing enterocolitis, retinopathy of prematurity, and severe intraventricular hemorrhage. 49 As such, our findings may be more applicable to large referral centers with a heterogeneous case mix.…”

Section: Discussionmentioning

confidence: 99%

Mortality Risk Factors in Preterm Infants Treated with High-Frequency Jet Ventilation

et al. 2020

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BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for premature infants with respiratory failure. We sought to identify parameters that were associated with mortality in subjects who underwent HFJV. METHODS: Subjects were enrolled if birthweight was^2,000 g and they were^34 weeks gestational age. Subjects were excluded if they received HFJV at the time of admission because we aimed to study subjects who failed conventional ventilation. Subject demographics, ventilator parameters, and laboratory data were extracted and analyzed. The Mann-Whitney U-test was used to assess differences in continuous variables, and the chi-square and Fisher exact tests were used for categorical variables between the groups. To assess variables that were predictive of mortality, we used both univariate and multivariate logistic regression analysis. Independent predictors of mortality were identified and used to create a multivariate risk score. Receiver operating characteristic curves were constructed to evaluate the predictive accuracy of the multivariate risk score. RESULTS: A total of 53 premature subjects (n 5 37 male) were studied, of whom 39 (74%) survived to discharge or transfer back to referring hospital. In the univariate model, female sex, older gestational age, higher birthweight, HFJV peak inspiratory pressure at 1 h, and oxygen saturation index at 4 h were associated with mortality. In the final multivariate logistic regression model, female sex (odds ratio 4.1, 95% CI 1.2-19.8, P 5 .044), closed ductus arteriosus (odds ratio 7.7, 95% CI 1.3-39.5, P 5 .016), and oxygen saturation index > 5.5 (odds ratio 6.0, 95% CI 1.5-28.3, P 5 .02) were independent predictors of mortality. CONCLUSIONS: We identified that oxygen saturation index > 5.5 after 4 h of HFJV, female sex, and closed ductus arteriosus were independent predictors of mortality.

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Section: Discussionmentioning

confidence: 99%

Mortality Risk Factors in Preterm Infants Treated with High-Frequency Jet Ventilation

et al. 2020

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“…A case-control study involving 50 infants who received HFJV tracked death before discharge or discharge on oxygen as the primary outcomes. 11 HFJV was initiated due to pulmonary interstitial emphysema or failure to respond to conventional ventilation or HFOV. Oxygenation failure was defined as P aw $ 10 cm H 2 O and F IO 2 > 0.30 or ventilation failure (P aCO 2 > 45 mm Hg and pH < 7.20) with a V T of 4-6 mL/kg.…”

Section: Retrospective Studiesmentioning

confidence: 99%

“…8,9 Despite the lack of high-quality evidence, the use of HFJV may be increasing as there have been a number of single-center experiences published since 2015. [8][9][10][11][12] The purpose of this review is to discuss the physiologic principles behind HFJV, examine the evidence supporting its use in neonatal and pediatric ICUs, give meaningful guidance for clinical application, and highlight potential areas for future research.…”

Section: Introductionmentioning

confidence: 99%

High-Frequency Jet Ventilation in Neonatal and Pediatric Subjects: A Narrative Review

2021

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High-frequency ventilation is commonly utilized with neonates and with children with severe respiratory failure. Both high-frequency oscillatory ventilation (HFOV) and high-frequency jet ventilation (HFJV) are used extensively in neonates. HFJV can also be used in older, larger children. The purpose of this narrative review is to discuss the physiologic principles behind HFJV, examine the evidence supporting its use in neonatal and pediatric ICUs, give meaningful guidance for clinical application, and highlight potential areas for future research.

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“…A summary of the most recent studies using these compounds and the most significant outcomes are shown in Table 3. [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] These studies have provided useful information on the effectiveness and pharmacological properties of various therapeutic agents, as well as other treatments for sepsis, inflammation, and concurrent infection in BPD patients. 57,58,60 Of the most frequently used therapeutic agents for BPD management, the two most common compounds are caffeine and vitamin A.…”

Section: Experimental Therapeutics: Recent Clinical Studiesmentioning

confidence: 99%

“…[45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] These studies have provided useful information on the effectiveness and pharmacological properties of various therapeutic agents, as well as other treatments for sepsis, inflammation, and concurrent infection in BPD patients. 57,58,60 Of the most frequently used therapeutic agents for BPD management, the two most common compounds are caffeine and vitamin A. These are used either alone or in combination with ventilation management strategies, inhaled nitric oxide administration, systemic corticosteroid treatment, and other nutritional interventions.…”

Section: Experimental Therapeutics: Recent Clinical Studiesmentioning

confidence: 99%

Bronchopulmonary Dysplasia: An Update on Experimental Therapeutics

Naeem

Ahmed

Silveyra

2019

EMJ

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Bronchopulmonary dysplasia (BPD) is a chronic inflammatory lung disease that affects thousands of newborns and infants every year. Although it is accepted that BPD results from lung damage and inflammation triggered by mechanical ventilation and hyperoxia, the causes and molecular events leading to lung damage and arrested development remain unknown. While recent advances in neonatal care have improved the survival of very low-weight infants, the rates of BPD have not improved accordingly. This is mainly due to our limited understanding of the disease’s pathogenesis and the effective therapeutic options available. Current therapeutics for BPD involve ventilation management, steroid treatment, and administration of various agents, such as pulmonary surfactant, caffeine, vitamin A, nitric oxide, and stem cells. However, the efficacy of these agents in preventing and ameliorating BPD symptoms varies depending on the populations studied and the disease stage. As the field moves towards personalised therapeutic approaches, this review summarises clinical and experimental studies conducted in various models, aiming to increase understanding of the cellular and molecular mechanisms by which these agents can prevent or treat BPD. Due to the increasing number of extremely premature infants, it is imperative that we continue to work towards understanding the mechanisms of BPD pathogenesis and generating more effective therapeutic options.

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High frequency jet ventilation in preterm infants: experience from Western Australia

Abstract: HFJV was not associated with reduced odds of death or discharge home on oxygen in preterm infants in our study. Adequately powered randomized trials are required to assess the efficacy and safety of HFJV in preterm infants.

Cited by 6 publications

References 8 publications

Mortality Risk Factors in Preterm Infants Treated with High-Frequency Jet Ventilation

Mortality Risk Factors in Preterm Infants Treated with High-Frequency Jet Ventilation

High-Frequency Jet Ventilation in Neonatal and Pediatric Subjects: A Narrative Review

Bronchopulmonary Dysplasia: An Update on Experimental Therapeutics

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