The adverse effects of non-invasive high-frequency oscillatory ventilation on the cerebral hemodynamics of premature infants: point-of-care brain ultrasound findings from a case-series study

Objective In recent years, non-invasive high-frequency oscillatory ventilation (NHFOV) has been widely used in clinical practice for premature infants with respiratory distress. However, until now, the focus of all published studies has been on the effect of NHFOV on patient's respiratory system, and its impact on the neonatal cerebral hemodynamics has not been considered. Method We monitored the hemodynamics of the anterior cerebral arteries of 10 premature infants who received NHFOV treatment because of respiratory distress and compared them with the cerebral hemodynamics of patients who received invasive high-frequency oscillatory ventilation (IHFOV), invasive conventional mechanical ventilation (IMV), nasal continuous positive airway pressure (NCPAP), and those who did not receive ventilator treatment at the same time. Results The results of this study revealed that NHFOV can have serious adverse effects on the cerebral hemodynamics of infants and subsequently lead to brain damage. Most importantly, this adverse effect of NHFOV is even more severe than that caused by IHFOV and IMV. Conclusion Given that NHFOV has a severely adverse effect on the cerebral hemodynamics of patients compared with other non-invasive ventilation modes, it does not have any distinct advantages; therefore, we believe that NHFOV should be used with caution in premature infants, especially those who are extremely premature.