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01-03-2005 | Neonatal and Pediatric Intensive Care

HFOV in premature neonates: effects on pulmonary mechanics and epithelial lining fluid cytokines. A randomized controlled trial

Authors: Giovanni Vento, Piero G. Matassa, Franco Ameglio, Ettore Capoluongo, Enrico Zecca, Luca Tortorolo, Mara Martelli, Costantino Romagnoli

Published in: Intensive Care Medicine | Issue 3/2005

Abstract

Objective

Ventilation strategies for preterm neonates may influence the severity of pulmonary dysfunction and later development of chronic lung disease. The objective of this report is to compare the effects of high-frequency oscillatory ventilation (HFOV) versus synchronized intermittent mandatory ventilation (sIMV) from the points of views of biochemical and functional variables.

Design

Randomized controlled trial.

Setting

Third level NICU.

Patients and participants

Forty preterm neonates with a gestational age of 24–29 weeks were randomly assigned to one of the two above-mentioned ventilation strategies within 30 min from birth.

Measurements and results

At 1, 3, 5, and 7 days, the babies were monitored by means of ventilator indices, pulmonary function, and eight pro-inflammatory or anti-inflammatory cytokines measured in bronchoalveolar lavage fluid. The neonates assigned to the HFOV procedure benefited from early and sustained improvement in pulmonary mechanics and gas exchange—significantly higher dynamic respiratory compliance values, significantly lower expiratory airway resistance and oxygenation index values—with earlier extubation as compared to the neonates assigned to sIMV treatment, and showed significantly lower transforming growth factor-β1 concentrations in bronchoalveolar lavage fluid.

Conclusions

The results of this randomized clinical trial support the hypothesis that early and exclusive use of HFOV, combined with optimum volume strategy, has a beneficial effect during the acute phase of lung injury.

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Title: HFOV in premature neonates: effects on pulmonary mechanics and epithelial lining fluid cytokines. A randomized controlled trial
Authors: Giovanni Vento
Piero G. Matassa
Franco Ameglio
Ettore Capoluongo
Enrico Zecca
Luca Tortorolo
Mara Martelli
Costantino Romagnoli
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2556-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

HFOV in premature neonates: effects on pulmonary mechanics and epithelial lining fluid cytokines. A randomized controlled trial

Abstract

Objective

Design

Setting

Patients and participants

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients and participants

Measurements and results

Conclusions

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