PEDIATRICS Vol. 72 No. 1 July 1983, pp. 27-32
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Neonatal High-Frequency Jet Ventilation

Thomas Pokora MD1, Dennis Bing RRT1, Mark Mammel MD1, and Stephen Boros MD1

1 From The Children's Hospital, St. Paul, and Department of Pediatrics, University of Minnesota Medical School, Minneapolis

Ten neonates with intractable respiratory failure were treated with high-frequency jet ventilation (HFJV). Nine had progressive pulmonary air leaks with either bronchopleural fistulas or pulmonary interstitial emphysema as the primary cause of their respiratory failure. Following HFJV, x-ray film evidence of pulmonary air leaks decreased in seven of the nine neonates. Pao2/FIO2 increased in eight of the ten patients (P <. 05), and Paco2 values decreased in nine of the ten patients (P < .01). Five patients survived. Three of the six patients exposed to HFJV for more than 20 hours developed significant tracheal obstruction. From this experience, it may be concluded that HFJV can successfully ventilate certain neonates with intractable respiratory failure secondary to progressive pulmonary air leaks. In its present form, long-term neonatal HFJV carries a risk of airway obstruction and/or damage.

Key Words: high-frequency jet ventilation • pulmonary air leaks • tracheal obstruction

Submitted on July 8, 1982