Nasal high frequency ventilation in neonates with moderate respiratory insufficiency

AIM: To investigate the efficacy of nasal high frequency ventilation (nHFV) in newborn infants with moderate respiratory insufficiency. METHOD: Twenty one preterm and term neonates were treated with nHFV for respiratory insufficiency. Criteria for starting nHFV were: deterioration on nasal CPAP expressed by a median pH of 7.24 and pCO2 of 8.3 kPa, or increasing FIO2. nHFV was delivered using the Infant Star ventilator. Ventilator setting amplitude was 35 cm H2O; mean airway pressure 7 cm H2O; and frequency 10 Hz. RESULTS: pCO2 decreased significantly from 8.3 kPa to 7.2 kPa after nHFV was started. In five patients nHFV was discontinued after a median period of 6 1/2 hours due to CO2 retention and high oxygen need, and endotracheal mechanical ventilation was started. CONCLUSIONS: nHFV can reduce pCO2 in neonates with moderate respiratory insufficiency and, therefore, could be used to decrease the need for endotracheal mechanical ventilation.