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American Academy of Pediatrics
Article

Childhood Outcome After Early High-Frequency Oscillatory Ventilation for Neonatal Respiratory Distress Syndrome

Dale R. Gerstmann, Kari Wood, Annie Miller, Mike Steffen, Bob Ogden, Ronald A. Stoddard and Stephen D. Minton
Pediatrics September 2001, 108 (3) 617-623; DOI: https://doi.org/10.1542/peds.108.3.617
Dale R. Gerstmann
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Kari Wood
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Annie Miller
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Mike Steffen
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Bob Ogden
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Ronald A. Stoddard
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Stephen D. Minton
1From the Department of Neonatology, Utah Valley Regional Medical Center, Provo, Utah.
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Abstract

Objective. In a previous multicenter controlled clinical trial, we randomly assigned surfactant-treated premature newborns with moderate to severe respiratory distress syndrome to early treatment with high-frequency oscillatory ventilation (HFOV) or to conventional ventilation (CV). Compared with control infants who were treated with CV, neonates who were treated with HFOV using a strategy designed to recruit and maintain lung volume and minimize oxygen exposure had clinical evidence of improved pulmonary outcome and less lung injury. We report a follow-up study designed to determine whether clinical differences persisted between these study groups.

Methods. Patients were recruited from 81 survivors at 1 center (Provo, Utah) and evaluated for sociodemographic and health history, growth, mental development, motor proficiency, and pulmonary function.

Results. Eighty-seven percent of the cohort who originally were assigned to treatment with HFOV (n = 36) or CV (n = 33) were seen in follow-up at a mean age of 77 months (6.4 years). There were no differences in the frequency of hospitalization, pulmonary illness, asthma, or disabilities. Growth, verbal IQ, and motor development were appropriate for age and not different between groups. Patients who initially were randomized to treatment with CV showed pulmonary function evidence of decreased peak expiratory flow, increased residual lung volume, and maldistribution of ventilation.

Conclusion. Neurodevelopmental childhood outcome after early intervention HFOV was normal and not different compared with patients who were treated with CV. Surfactant replacement combined with early HFOV using a lung recruitment strategy ameliorates the acute lung injury in respiratory distress syndrome that predisposes some preterm infants to develop chronic lung disease.

  • respiratory distress syndrome
  • high-frequency oscillatory ventilation
  • chronic lung disease
  • neurodevelopmental outcome
  • pulmonary function
  • obstructive lung disease
  • Received September 18, 2000.
  • Accepted January 15, 2001.
  • Copyright © 2001 American Academy of Pediatrics

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Pediatrics
Vol. 108, Issue 3
1 Sep 2001
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Childhood Outcome After Early High-Frequency Oscillatory Ventilation for Neonatal Respiratory Distress Syndrome
Dale R. Gerstmann, Kari Wood, Annie Miller, Mike Steffen, Bob Ogden, Ronald A. Stoddard, Stephen D. Minton
Pediatrics Sep 2001, 108 (3) 617-623; DOI: 10.1542/peds.108.3.617

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Childhood Outcome After Early High-Frequency Oscillatory Ventilation for Neonatal Respiratory Distress Syndrome
Dale R. Gerstmann, Kari Wood, Annie Miller, Mike Steffen, Bob Ogden, Ronald A. Stoddard, Stephen D. Minton
Pediatrics Sep 2001, 108 (3) 617-623; DOI: 10.1542/peds.108.3.617
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