Early High Frequency Oscillatory Ventilation in Pediatric Acute Respiratory Failure

Abstract
Background: High frequency oscillatory ventilation (HFOV) has been a staple in the management of children with acute respiratory failure (ARF). HFOV is a mode of mechanical ventilation that recruits diseased lung and improves oxygen-ation through the use of high mean airway pressures with tidal volumes less than anatomic dead space. Although HFOV is commonly used in children, efficacy data are limited and predate the era of low tidal volume (Vt) conventional mechan-ical ventilation (CMV).
Aim of the Study: It was to compare the impact of early high frequency oscillatory ventilation (within 24-48 hours of endotracheal intubation) to conventional mechanical ventilation and/or late high frequency oscillatory ventilation in children with acute respiratory failure.
Patients and Methods: The study was carried out on thirty patients with acute respiratory failure (ARF) who attended to the pediatric intensive care unit, Pediatric Department, Tanta University Hospital. All studied children were subjected to detailed history taking, complete physical examination, mon-itoring of SV, SVI, CO, CI, SVR, SVRI through trans-esophageal doppler monitoring and oxygenation index.
Results: There was significant decrease of O2Sat of Early HFOV group compared with P-CMV and Late HFOV. there was significant increase of O2Sat in Early HFOV in 2nd and 3rd days compared with 1st day There was significant decrease of oxygenation index in late HFOV and P-CMV groups compared with Early HFOV group. It is one of most important prognostic factors for detection timing of HFOV according to ROC curve.
Conclusion: As hypoxia worsened, patient percentage with Early HFOV increased Oxygenation index was significant as a predictor and prognostic factor for early HFOV success.