Effects of Pressure Support Ventilation Plus Volume Guarantee vs. High‐frequency Oscillatory Ventilation on Lung Inflammation in Preterm Infants

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Abstract
The aim of the present study was to evaluate if high‐frequency oscillatory ventilation (HFOV) might reduce lung inflammation in preterm infants with infant respiratory distress syndrome (RDS) in comparison with the early application of another potentially lung‐protective ventilation strategy, such as pressure support ventilation plus volume guarantee (PSV + VG). Infants at less than 30 weeks of gestation with RDS were enrolled consecutively in the study if they required mechanical ventilation, and were randomly allocated to receive HFOV or PSV + VG. Bronchial aspirate samples for the measurement of interleukin (IL)‐1β, IL‐8, and IL‐10 were obtained before surfactant treatment (T1), after 6–18 hr of ventilation (T2), after 24–48 hr of ventilation (T3), and before extubation (T4). Thirteen patients were enrolled in the HFOV group, and 12 in the PSV + VG group. The mean values of IL‐1β, IL‐8, and IL‐10 at T4 were lower in the HFOV group than in the PSV + VG group. The present study demonstrates that early treatment with HFOV is associated with a reduction of lung inflammation in comparison with PSV + VG in preterm infants with RDS. Pediatr Pulmonol.