Objective: High frequency percussive ventilation (HFPV) is used in acute respiratory failure, but is poorly described in pediatrics. We aimed to describe the clinical characteristics, ventilator settings, and outcomes of a large pediatric cohort, and to determine predictors of who would benefit from HFPV.
Hypothesis: Gas exchange 2 h after HFPV initiation predicts success.
Design: Single center retrospective cohort study testing association between gas exchange 2 h after HFPV initiation with success, defined a priori.
Patients: Intubated children on HFPV for ≥2 h from 2012 to 2018.
Methods: We described indications, ventilator settings, and gas exchange immediately before, 2 h after, and at termination of HFPV. Univariate and multivariate regression tested association of oxygenation and ventilation after HFPV initiation with success. Areas under the receiver operating characteristic (AUROC) curve and adjusted odds ratios (aORs) were computed.
Results: We performed 237 courses of HFPV in 193 children (22% non-survivors), of which 162 (68%) were successful. In univariate analysis, pH (AUROC, 0.65) and PCO (AUROC, 0.66) 2 h after HFPV predicted success. In multivariate analysis, pH (aOR: 1.67 per 1 SD; 95% confidence interval [CI]: 1.19-2.35), PCO (aOR: 0.49 per 1 SD; 95% CI: 0.31-0.79), and oxygenation index (aOR: 0.66 per 1 SD; 95% CI: 0.44-0.97) 2 h after HFPV initiation were associated with success.
Conclusion: We describe the largest cohort of HFPV to date, with detailed description of indications and settings. Gas exchange after 2 h of HFPV was independently associated with success.
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| http://dx.doi.org/10.1002/ppul.25191 | DOI Listing |
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High-frequency percussive ventilation in acute respiratory failure.
ERJ Open Res
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Anaesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Introduction: High-frequency percussive ventilation (HFPV) is a ventilation mode characterised by high-frequency breaths. This study investigated the impact of HFPV on gas exchange and clinical outcomes in acute respiratory failure (ARF) patients during spontaneous breathing, noninvasive ventilation (NIV) and invasive mechanical ventilation (iMV).
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Children (Basel)
October 2024
Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, and New York Medical College, Valhalla, NY 10595, USA.
Article Synopsis
- The study examined high-frequency percussive ventilation (HFPV) as a potential rescue treatment for extremely low gestational age neonates (ELGANs) suffering from severe lung disease.
- It involved a retrospective review of 16 ELGANs (average gestational age of 25 weeks and birth weight of 640 grams) who had not improved after other ventilation methods, with a noted 31% mortality rate.
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Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
Abdominal inflation with CO is used to facilitate laparoscopic surgeries, however, providing adequate mechanical ventilation in this scenario is of major importance during anesthesia management. We characterized high-frequency percussive ventilation (HFPV) in protecting from the gas exchange and respiratory mechanical impairments during capnoperitoneum. In addition, we aimed to assess the difference between conventional pressure-controlled mechanical ventilation (CMV) and HFPV modalities generating the high-frequency signal intratracheally (HFPVi) or extrathoracally (HFPVe).
View Article and Find Full Text PDFVenovenous extracorporeal membrane oxygenation for respiratory failure refractory to high frequency percussive ventilation.
Heart Lung
March 2024
Department of Cardiothoracic Surgery, New York Presbyterian Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10065, USA; Department of Cardiothoracic Surgery, New York Presbyterian Queens Hospital, 56-45 Main Street, Flushing, NY 11355.
Background: High frequency percussive ventilation (HFPV) has demonstrated improvements in gas exchange, but not in clinical outcomes.
Objectives: We utilize HFPV in patients failing conventional ventilation (CV), with rescue venovenous extracorporeal membrane oxygenation (VV ECMO) reserved for failure of HFPV, and we describe our experience with such a strategy.
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Neonatal resuscitation with continuous chest compressions and high frequency percussive ventilation in preterm lambs.
Pediatr Res
January 2024
Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, CA, USA.
Background: Cerebral oxygen delivery (cDO) is low during chest compressions (CC). We hypothesized that gas exchange and cDO are better with continuous CC with high frequency percussive ventilation (CCC + HFPV) compared to conventional 3:1 compressions-to-ventilation (C:V) resuscitation during neonatal resuscitation in preterm lambs with cardiac arrest induced by umbilical cord compression.
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