Document Detail


Preliminary observations of the use of high-frequency jet ventilation as rescue therapy in infants with congenital diaphragmatic hernia.
MedLine Citation:
PMID:  20385273     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Congenital diaphragmatic hernia (CDH) is associated with mortality of 10% to 50%. Several investigators have reported outcomes from centers using high-frequency oscillatory ventilation in their management of CDH, but there are no recent reports on use of high-frequency jet ventilation.
METHODS: During the study period from January 2001 until August 2007, infants with CDH who were cared for at Duke University Medical Center received high-frequency jet ventilation as a rescue mode of high-frequency ventilation. We compared actual survival with predicted survival for infants treated only with conventional ventilation vs those rescued with high-frequency jet ventilation after failing conventional ventilation.
RESULTS: Survival for the 16 infants that received high-frequency jet ventilation was predicted to be 63%; actual survival was 75%. Survival for the 15 infants that received only conventional ventilation was predicted to be 83%; actual survival was 87%. We observed no significant survival benefit for high-frequency jet ventilation, 8.0% (95 confidence interval, -22.0% to 38.1%; P = .59).
CONCLUSIONS: Although our sample size was small, we conclude with consideration of the absolute results, the degree of illness of the infants, and the biologic plausibility for the intervention that high-frequency jet ventilation is an acceptable rescue ventilation mode for infants with CDH.
Authors:
Michael A Kuluz; P Brian Smith; Sarah P Mears; Jennifer R Benjamin; Elisabeth T Tracy; W Lee Williford; Ronald N Goldberg; Henry E Rice; C Michael Cotten
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  698-702     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Duke University, Durham, NC, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Hernia, Diaphragmatic / congenital*,  therapy*
High-Frequency Jet Ventilation*
Humans
Infant, Newborn
Male
North Carolina
Survival Analysis
Grant Support
ID/Acronym/Agency:
K23 HD060040-01/HD/NICHD NIH HHS
Comments/Corrections

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