Neonatal High-Frequency Jet Ventilation

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Abstract
Neonates (10) with intractable respiratory failure were treated with high-frequency jet ventilation (HFJV). Nine had progressive pulmonary air leaks with either bronchopleural fistulas or pulmonary interstitial emphysema as the primary cause of their respiratory failure. Following HFJV, X-ray film evidence of pulmonary air leaks decreased in 7 of the 9 neonates. PaO2[arterial O2 partial pressure]/FIO2 [fractional concentration of CO2 in inspired gas] increased in 8 of the 10 patients (P < 0.05), and PaCO2 values decreased in 9 of the 10 patients (P < 0.01). Five patients survived. Three of the 6 patients exposed to HFJV for > 20 h developed significant tracheal obstruction. HFJV can successfully ventilate certain neonates with intractable respiratory failure secondary to progressive pulmonary air leaks. In its present form, long-term neonatal HFJV carries a risk of airway obstruction and/or damage.

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