Lung Recruitment Using High-Frequency Oscillation Volume Guarantee in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Abstract

<b><i>Background:</i></b> Stepwise lung recruitment maneuvers (LRMs) may be used in ventilated preterm infants. However, its use in high-frequency oscillation with volume guarantee (HFO-VG) is not well studied. <b><i>Methods:</i></b> Preterm infants treated with HFO-VG who had LRMs were identified. Patient and respiratory parameters were recorded. <b><i>Results:</i></b> Ten infants, median GA 25<sup>+6</sup> (IQR 24<sup>+2</sup>–27<sup>+0</sup>) weeks, and 21 LRMs were identified. LRMs were performed at a median age of 26 days, with a starting MAP of 16 (14–17) cm H<sub>2</sub>O and the highest MAP of 23.5 (22.0–24.8) cm H<sub>2</sub>O. Most (76%) resulted in immediate improved SpO<sub>2</sub>/FiO<sub>2.</sub> There were no sustained differences in median oxygen saturation index (8.4 vs. 9, <i>p</i> = 0.09), SpO<sub>2</sub>/FiO<sub>2</sub> (1.8 vs. 1.8, <i>p</i> = 0.8), ∆P (21 vs. 23, <i>p</i> = 0.64), or transcutaneous CO<sub>2</sub> (58 vs. 60, <i>p</i> = 0.84) in 24 h before and after LRMs. <b><i>Conclusions:</i></b> In preterm infants with evolving bronchopulmonary dysplasia, LRMs on HFO-VG did not result in sustained improvement to oxygenation or ventilation.