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September 14, 2026Frontiers in PediatricsOpen Access

High-frequency percussive ventilation in pediatric acute respiratory failure in a community-based pediatric intensive care unit

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Authors

JPJuan Sebastian ProañoDJDaniel JayasuriyaBTBalagangadhar Totapally

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Overview

Retrospective cohort study finds that stagnant oxygenation index predicts percussive ventilation failure in children, suggesting early oxygen saturation tracking can guide critical transfers.

Key Points

  • Evaluate outcomes of high-frequency percussive ventilation (HFPV) and determine whether early changes in oxygen saturation index (OSI) predict HFPV failure in a community-based pediatric ICU lacking extracorporeal support.
  • Conducted a single-center retrospective cohort study of intubated pediatric patients (N=31) with acute respiratory failure who received HFPV for ≥12 hours from 2018 to 2023 in a 10-bed PICU without ECMO capability.
  • Defined HFPV failure as death or interfacility transfer for higher-level cardiopulmonary support, evaluating changes in OSI (delta-OSI) over time using receiver operating characteristic (ROC) curves.
  • HFPV failure occurred in 23% of patients (7/31), including 5 deaths (16%) and 2 transfers for advanced cardiopulmonary support (7%).
  • Patients with treatment failure exhibited higher median OSI at 24 hours than successfully managed patients (21.7 [IQR 6.4–22.0] vs. 10.3 [IQR 8.0–15.2]).
  • The discriminative ability of delta-OSI to identify impending ventilation failure strengthened over time, reaching the highest area under the ROC curve at 24 hours.

Cite This Study

Proaño et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b32d0926e14a848b1fbbhttps://doi.org/10.3389/fped.2026.1864661
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