An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation

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dc.authoridMert, Mustafa Kurthan/0000-0002-2789-2710
dc.authoridCalkavur, Sebnem/0000-0002-3820-2690
dc.authoridGokmen Yildirim, Tulin/0000-0001-5951-2631
dc.authoridKonak, Murat/0000-0001-8728-4541
dc.authoridaksu, meltem/0000-0002-0045-0082
dc.authoridAtasay, Fatma Begum/0000-0002-9114-5293
dc.authoridECEVİT, AYSE/0000-0002-2232-8117
dc.authorwosidGökçe, İsmail Kürşad/ABI-8128-2020
dc.authorwosidMert, Mustafa Kurthan/JVO-9833-2024
dc.authorwosidCalkavur, Sebnem/JGE-3009-2023
dc.authorwosidERDEVE, Omer/W-1480-2017
dc.authorwosidCelik, Yalcin/AAA-4342-2021
dc.authorwosidGokmen Yildirim, Tulin/HJH-4905-2023
dc.authorwosidKonak, Murat/B-2334-2018
dc.contributor.authorErdeve, Omer
dc.contributor.authorOkulu, Emel
dc.contributor.authorTunc, Gaffari
dc.contributor.authorCelik, Yalcin
dc.contributor.authorKayacan, Ugur
dc.contributor.authorCetinkaya, Merih
dc.contributor.authorBuyukkale, Gokhan
dc.date.accessioned2024-08-04T20:46:00Z
dc.date.available2024-08-04T20:46:00Z
dc.date.issued2019
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground To achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently. Methods An online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment. The study population consisted of 372 infants with CV failure after at least 4 hours of treatment in 23 participating NICUs. Patients were grouped according to their final outcome as survived (Group S) or as died or received extracorporeal membrane oxygenation (ECMO) (Group D/E). Patients' demographic characteristics and underlying diseases in addition to their ventilator settings, arterial blood gas (ABG) analysis results at 0, 1, 4, and 24 hours, type of device, ventilation duration, and complications were compared between groups. Results HFOV as rescue treatment was successful in 58.1% of patients. Demographic and treatment parameters were not different between groups, except that infants in Group D/E had lower birthweight (BW) (1655 +/- 1091 vs. 1858 +/- 1027 g, p = 0.006), a higher initial FiO2 setting (83% vs. 72%, p < 0.001), and a higher rate of nitric oxide exposure (21.8% vs. 11.1%, p = 0.004) in comparison to infants who survived (Group S). The initial cut-offs for a successful response on ABG were defined as pH > 7.065 (OR: 19.74, 95% CI 4.83-80.6, p < 0.001), HCO3 > 16.35 mmol/L (OR: 1.06, 95% CI 1.01-1.1, p = 0.006), and lactate level < 3.75 mmol/L (OR: 1.09% 95 CI 1.01-1.16, p = 0.006). Rescue HFOV duration was associated with retinopathy of prematurity (p = 0.005) and moderate or severe chronic lung disease (p < 0.001), but not with patent ductus arteriosus or intraventricular hemorrhage, in survivors (p > 0.05). Conclusion Rescue HFOV as defined for this population was successful in more than half of the patients with CV failure. Although the response was not associated with gestational age, underlying disease, device used, or initial MV settings, it seemed to be more effective in patients with higher BW and those not requiring nitric oxide. Initial pH, HCO3, and lactate levels on ABG may be used as predictors of a response to rescue HFOV.en_US
dc.description.sponsorshipTurkish Neonatal Society [5-2016]en_US
dc.description.sponsorshipThis study was supported by the Turkish Neonatal Society, number 5-2016, received by OE. Turkish Neonatal Society funded the study's online registry system. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.en_US
dc.identifier.doi10.1371/journal.pone.0217768
dc.identifier.issn1932-6203
dc.identifier.issue6en_US
dc.identifier.pmid31181092en_US
dc.identifier.scopus2-s2.0-85066992292en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0217768
dc.identifier.urihttps://hdl.handle.net/11616/98823
dc.identifier.volume14en_US
dc.identifier.wosWOS:000470854200027en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherPublic Library Scienceen_US
dc.relation.ispartofPlos Oneen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCongenital Diaphragmatic-Herniaen_US
dc.subjectMechanical Ventilationen_US
dc.subjectTerm Infantsen_US
dc.subjectManagementen_US
dc.subjectFailureen_US
dc.subjectTrialen_US
dc.titleAn observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilationen_US
dc.typeArticleen_US

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