Objective To investigate the efficacy of volume-guaranteed high-frequency oscillatory ventilation (HFOV-VG) in preterm infants with respiratory distress syndrome (RDS) and its impact on blood flow in the middle cerebral artery (MCA). Methods A prospective study was conducted on 120 preterm infants with RDS who were admitted to the Department of Neonatology at Qinhuangdao Maternal and Child Health Hospital from March 2020 to December 2023. According to the mode of ventilation, the infants were divided into two groups: a conventional mechanical ventilation (CMV) group (60 infants) and an HFOV-VG group (60 infants). The two groups were compared in terms of baseline data, MCA hemodynamic parameters, complications, and outcomes. Results Compared with the CMV group, the HFOV-VG group had significantly shorter durations of mechanical ventilation and hospital stay and a significantly higher overall response rate (P<0.05). The HFOV-VG group demonstrated significantly better peak systolic velocity, end-diastolic velocity, and mean flow velocity (P<0.05). The HFOV-VG group also exhibited significantly lower 28-day mortality rates and lower incidence rates of bronchopulmonary dysplasia and intraventricular hemorrhage than the CMV group (P<0.05). Conclusions HFOV-VG can effectively improve cerebral blood perfusion, reduce cerebrovascular resistance, shorten the durations of mechanical ventilation and hospital stay, and enhance overall treatment efficacy. It has significant advantages in reducing the risk of 28-day mortality, bronchopulmonary dysplasia, and intraventricular hemorrhage in preterm infants with RDS.
Key words
Respiratory distress syndrome /
Volume-guaranteed high-frequency oscillatory ventilation /
Cerebral blood flow /
Efficacy /
Preterm infant
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
1 Dargaville PA, Kamlin COF, Orsini F, et al. Effect of minimally invasive surfactant therapy vs sham treatment on death or bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: the OPTIMIST-A randomized clinical trial[J]. JAMA, 2021, 326(24): 2478-2487. PMID: 34902013. PMCID: PMC8715350. DOI: 10.1001/jama.2021.21892.
2 Bos LDJ, Ware LB. Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes[J]. Lancet, 2022, 400(10358): 1145-1156. PMID: 36070787. DOI: 10.1016/S0140-6736(22)01485-4.
3 Pelosi P, Ball L, Barbas CSV, et al. Personalized mechanical ventilation in acute respiratory distress syndrome[J]. Crit Care, 2021, 25(1): 250. PMID: 34271958. PMCID: PMC8284184. DOI: 10.1186/s13054-021-03686-3.
4 Reynolds P, Bustani P, Darby C, et al. Less-invasive surfactant administration for neonatal respiratory distress syndrome: a consensus guideline[J]. Neonatology, 2021, 118(5): 586-592. PMID: 34515188. DOI: 10.1159/000518396.
5 Bitker L, Talmor D, Richard JC. Imaging the acute respiratory distress syndrome: past, present and future[J]. Intensive Care Med, 2022, 48(8): 995-1008. PMID: 35833958. PMCID: PMC9281340. DOI: 10.1007/s00134-022-06809-8.
6 Bittner E, Sheridan R. Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients[J]. Surg Clin North Am, 2023, 103(3): 439-451. PMID: 37149380. PMCID: PMC10028407. DOI: 10.1016/j.suc.2023.01.006.
7 Deming RS, Mazzola E, MacDonald J, et al. Care intensity and palliative care in chronically critically ill infants[J]. J Pain Symptom Manage, 2022, 64(5): 486-494. PMID: 35840043. DOI: 10.1016/j.jpainsymman.2022.07.002.
8 Dumpa V, Avulakunta I, Bhandari V. Respiratory management in the premature neonate[J]. Expert Rev Respir Med, 2023, 17(2): 155-170. PMID: 36803028. DOI: 10.1080/17476348.2023.2183843.
9 Ramaswamy VV, Abiramalatha T, Bandyopadhyay T, et al. Surfactant therapy in late preterm and term neonates with respiratory distress syndrome: a systematic review and meta-analysis[J]. Arch Dis Child Fetal Neonatal Ed, 2022, 107(4): 393-397. PMID: 34686533. DOI: 10.1136/archdischild-2021-322890.
10 Yu X, Tan Q, Li J, et al. Elective high frequency oscillatory ventilation versus conventional mechanical ventilation on the chronic lung disease or death in preterm infants administered surfactant: a systematic review and meta-analysis[J]. J Perinatol, 2025, 45(1):77-84. PMID: 39623024. DOI: 10.1038/s41372-024-02185-x.
11 Solís-García G, Ramos-Navarro C, González-Pacheco N, et al. Lung protection strategy with high-frequency oscillatory ventilation improves respiratory outcomes at two years in preterm respiratory distress syndrome: a before and after, quality improvement study[J]. J Matern Fetal Neonatal Med, 2022, 35(26): 10698-10705. PMID: 36521851. DOI: 10.1080/14767058.2022.2155040.
12 Silveira RC, Panceri C, Mun?z NP, et al. Less invasive surfactant administration versus intubation-surfactant-extubation in the treatment of neonatal respiratory distress syndrome: a systematic review and meta-analyses[J]. J Pediatr (Rio J), 2024, 100(1): 8-24. PMID: 37353207. PMCID: PMC10751720. DOI: 10.1016/j.jped.2023.05.008.
13 Miralizadeh A, Peyman A, Jamali Soltani N, et al. Comparison of the effect of foot and palm reflexology massage on respiratory distress syndrome in premature infants under noninvasive ventilation[J]. Complement Med Res, 2022, 29(2): 100-108. PMID: 34818220. DOI: 10.1159/000517982.
14 Lin HZ, Lin WH, Lin SH, et al. Application of high-frequency oscillation ventilation combined with volume guarantee in preterm infants with acute hypoxic respiratory failure after patent ductus arteriosus ligation[J]. Heart Surg Forum, 2022, 25(5): E709-E714. PMID: 36317914. DOI: 10.1532/hsf.4825.
15 Rodríguez Sánchez de la Blanca A, Sánchez Luna M, González Pacheco N, et al. New indicators for optimal lung recruitment during high frequency oscillator ventilation[J]. Pediatr Pulmonol, 2020, 55(12): 3525-3531. PMID: 32965770. DOI: 10.1002/ppul.25084.
16 Bhogal J, Solev?g AL, O'Reilly M, et al. Hemodynamic effects of high frequency oscillatory ventilation with volume guarantee in a piglet model of respiratory distress syndrome[J]. PLoS One, 2021, 16(2): e0246996. PMID: 33592023. PMCID: PMC7886162. DOI: 10.1371/journal.pone.0246996.
PDF(552 KB)
