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  • Title: Randomized trial of high-frequency oscillatory ventilation versus conventional ventilation: effect on systemic blood flow in very preterm infants.
    Author: Osborn DA, Evans N.
    Journal: J Pediatr; 2003 Aug; 143(2):192-8. PubMed ID: 12970631.
    Abstract:
    OBJECTIVE: Low superior vena cava (SVC) flow is common in very preterm infants in the first day and strongly associated with periventricular hemorrhage and disability. We examined the effect of high-frequency oscillatory ventilation (HFOV) compared with conventional ventilation (CV) on SVC flow and right ventricular output. METHODS: Forty-five infants <29 weeks were randomized before 1 hour of age to HFOV or CV. Echocardiography was performed on 43 infants at 3, 10, and 24 hours of age. Infants with low SVC flow (<50 mL/kg/min) or hypotension (mean blood pressure < or =20) were treated with volume and inotrope. RESULTS: Infants allocated to HFOV (n=23) and to CV (n=20) were well matched. There was a nonsignificant trend toward more infants on HFOV having SVC flow <50 mL/kg/min (48% vs 20%) and receiving volume and inotropes (61% vs 40%). There were no significant differences in mean SVC flow or right ventricular output at 3, 10, or 24 hours. Infants on HFOV had a significantly higher calculated upper body vascular resistance at 10 hours and mean blood pressure at 24 hours. CONCLUSIONS: There were no significant adverse effects of HFOV on systemic blood flow in very preterm infants during the first 24 hours of life.
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