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High-Frequency Oscillatory Ventilation for acute respiratory distress syndrome.
MedLine Citation:
PMID:  19475349     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effectiveness of HFOV in pediatric patients with acute respiratory distress syndrome. METHODS: In this retrospective study, we reviewed all 20 pediatric patients, who were consecutively ventilated with HFOV in the pediatric intensive care unit of a tertiary medical center, from January 2006 to February 2007. RESULTS: A total of 20 patients were enrolled. The median age of the subjects was 70 (3-168) months; 10 were male. All patients received conventional ventilation before HFOV. After initiation of HFOV, there was an immediate and sustained increase in PaO(2)/FiO(2) ratio. The PaO(2)/FiO(2) ratio was elevated and OI was decreased significantly after 10-20 minutes and maintained for at least 48 hours (p= 0.03, both). Thirteen of the 20 patients were successfully weaned. No significant change in the mean arterial pressure and heart rate was noted after HFOV. Overall survival rate was 65%. Of 20 patients, 11 patients suffered from extrapulmonary ARDS (ARDSexp) and 9 from pulmonary ARDS (ARDSp). When HFOV was initiated, there was significant increase in PaO(2)/FiO(2) and decrease in OI in ARDSexp compared to ARDSp (p= 0.03, both). Also mortality rate was significantly lower in patients with ARDSexp (9% vs.66%), (p= 0.01). CONCLUSION: In our study, HFOV was effective in oxygenation and seems to be safe for pediatric ARDS patients. HFOV affected ARDSp and ARDSexp paediatric patients differently. However prospective, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.
Authors:
Dincer Yildizdas; Hacer Yapicioglu; Ibrahim Bayram; Levent Yilmaz; Yasar Sertdemir
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Publication Detail:
Type:  Journal Article     Date:  2009-05-27
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  76     ISSN:  0973-7693     ISO Abbreviation:  Indian J Pediatr     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-11-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  921-7     Citation Subset:  IM    
Affiliation:
Cukurova University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Adana, Turkey. dyildizdas@cu.edu.tr
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