Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Safety and efficacy of high-frequency jet ventilation in neonatal transport

Journal of Perinatology volume 27, pages 609–613 (2007)Cite this article

Abstract

Objective:

To evaluate the safety and efficacy of high-frequency jet ventilation for transporting critically ill hypoxic neonates to an extracorporeal membrane oxygenation (ECMO) center.

Study Design:

We conducted a retrospective cohort study of 38 transported neonates. Safety was assessed by the comparison of cardiopulmonary variables before and after transport from referring hospital to our ECMO unit. Efficacy was assessed as the effect on ventilation and efficiency of pulmonary gas exchange after conversion from a conventional mechanical ventilator or a high-frequency oscillator to a high-frequency jet ventilator±inhaled nitric oxide.

Result:

The pre- and posttransport vital signs remained stable, regardless of the type of ventilator used. Pre-transport pneumothorax was the main problem, but no transport-related deaths occurred. We found significant improvement in the ventilation of the neonates transported with a high frequency jet ventilation±inhaled nitric oxide that were deficient in those transported with conventional mechanical ventilation+inhaled nitric oxide (P<0.05). The improvement started before transport upon changing the mode of ventilation to a high-frequency jet ventilator.

Conclusion:

Independent of the use of inhaled nitric oxide, high frequency jet ventilation appears to provide better ventilation than conventional mechanical ventilation and is safe to transport pre-ECMO neonates.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Butterfield LJ . Historical perspectives of neonatal transport. Pediatr Clin North Am 1993; 40 (2): 221–239.

    Article  CAS  Google Scholar 

  2. Hoehn T, Krause M, Hentschel R . High-frequency ventilation augments the effect of inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Eur Respir J 1998; 11 (1): 234–238.

    Article  CAS  Google Scholar 

  3. Baumgart S, Hirschl RB, Butler SZ, Coburn CE, Spitzer AR . Diagnosis-related criteria in the consideration of extracorporeal membrane oxygenation in neonates previously treated with high-frequency jet ventilation. Pediatrics 1992; 89 (3): 491–494.

    CAS  PubMed  Google Scholar 

  4. Kinsella JP, Abman SH . Inhaled nitric oxide: current and future uses in neonates. Semin Perinatol 2000; 24 (6): 387–395.

    Article  CAS  Google Scholar 

  5. Stewart DL, Dela Cruz TV, Duncan SD, Cook LN . Response to high frequency jet ventilation may predict the need for extracorporeal membrane oxygenation. Eur Respir J 1996; 9 (6): 1257–1260.

    Article  CAS  Google Scholar 

  6. Kinsella JP, Schmidt JM, Griebel J, Abman SH . Inhaled nitric oxide treatment for stabilization and emergency medical transport of critically ill newborns and infants. Pediatrics 1995; 95 (5): 773–776.

    CAS  PubMed  Google Scholar 

  7. Bergman KA, Geven WB, Molendijk A . Referral and transportation for neonatal extracorporeal membrane oxygenation. Eur J Emerg Med 2002; 9 (3): 233–237.

    Article  CAS  Google Scholar 

  8. Davis DA, Russo PA, Greenspan JS, Speziali G, Spitzer A . High-frequency jet versus conventional ventilation in infants undergoing Blalock–Taussig shunts. Ann Thorac Surg 1994; 57 (4): 846–849.

    Article  CAS  Google Scholar 

  9. Keszler M, Donn SM, Bucciarelli RL, Alverson DC, Hart M, Lunyong V et al. Multicenter controlled trial comparing high-frequency jet ventilation and conventional mechanical ventilation in newborn infants with pulmonary interstitial emphysema. J Pediatr 1991; 119 (1 part 1): 85–93.

    Article  CAS  Google Scholar 

  10. Dobyns EL, Anas NG, Fortenberry JD, Deshpande J, Cornfield DN, Tasker RC et al. Interactive effects of high-frequency oscillatory ventilation and inhaled nitric oxide in acute hypoxemic respiratory failure in pediatrics. Crit Care Med 2002; 30 (11): 2425–2429.

    Article  CAS  Google Scholar 

  11. Kinsella JP, Truog WE, Walsh WF, Goldberg RN, Bancalari E, Mayock DE et al. Randomized, multicenter trial of inhaled nitric oxide and high-frequency oscillatory ventilation in severe, persistent pulmonary hypertension of the newborn. J Pediatr 1997; 131 (1 part 1): 55–62.

    Article  CAS  Google Scholar 

  12. Hon KL, Olsen H, Totapally B, Leung TF . Air versus ground transportation of artificially ventilated neonates: comparative differences in selected cardiopulmonary parameters. Pediatr Emerg Care 2006; 22 (2): 107–112.

    Article  Google Scholar 

  13. Engle WA, Yoder MC, Andreoli SP, Darragh RK, Langefeld CD, Hui SL . Controlled prospective randomized comparison of high-frequency jet ventilation and conventional ventilation in neonates with respiratory failure and persistent pulmonary hypertension. J Perinatol 1997; 17 (1): 3–9.

    CAS  PubMed  Google Scholar 

  14. Platt DR, Swanton D, Blackney D . Inhaled nitric oxide (iNO) delivery with high-frequency jet ventilation (HFJV). J Perinatol 2003; 23 (5): 387–391.

    Article  CAS  Google Scholar 

  15. Plavka R, Dokoupilova M, Pazderova L, Kopecky P, Sebron V, Zapadlo M et al. High-frequency jet ventilation improves gas exchange in extremely immature infants with evolving chronic lung disease. Am J Perinatol 2006; 23 (8): 467–472.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Gail Barker for assisting in data collection and Dr Shirley K DeSimone for editing and critical reading of the manuscript.

Author information

Author notes

  1. H J Rozycki: HJ Rozycki served as the statistical reviewer on this paper

Authors and Affiliations

  1. Department of Pediatrics, Virginia Commonwealth University Health System, Richmond, VA, USA

    E S Mainali, H J Rozycki & G R Gutcher

  2. Department of Pediatrics, Medical Center at Women and Children's Hospital, University of Southern California, Los Angeles, CA, USA

    C Greene

Authors
  1. E S Mainali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Greene
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H J Rozycki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G R Gutcher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E S Mainali.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mainali, E., Greene, C., Rozycki, H. et al. Safety and efficacy of high-frequency jet ventilation in neonatal transport. J Perinatol 27, 609–613 (2007). https://doi.org/10.1038/sj.jp.7211799

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211799

Keywords

This article is cited by

Search

Advanced search

Quick links