CHANGES IN ARTERIAL BLOOD GAS VALUES AFTER NASAL HIGH-FREQUENCY OSCILLATORY VENTILATION FOR RESCUE STRATEGY IN PREVENTING INTUBATION IN NEONATES < 32 WEEKS AND < 1500 GRAMS

Abstract

Objective: Preterm infants with respiratory distress syndrome (RDS) often require varying degrees of respiratory support. Due to complications associated with mechanical ventilation and the low efficacy of other non-invasive ventilation methods (nCPAP, BiPAP, and NIPPV), we conducted a study to evaluate the effectiveness and complications of nasal high-frequency oscillatory ventilation (nHFOV).

Methods: Comparison of the mean changes in blood gas parameters (pH, PCO2, PO2, and BE) before and after using nHFOV in the neonatal intensive care unit in Children's Hospital 1 from August 1, 2018 to August 31, 2020.

Results: Twenty-six preterm infants received nHFOV for rescue indications. One infant was excluded from the sample due to the need for intubation for surfactant replacement therapy. Of the remaining infants, 20 (80%) were successfully treated with nHFOV, while 5 (20%) did not respond successfully to the method. The results showed a post-nHFOV arterial blood pCO2 of 42.7 ± 12 mmHg, and the arterial blood pH was 7.27 ± 0.06. The FiO2 decreased from 46% to 41% after nHFOV. In the successful group, there was a statistically significant difference in arterial blood pCO2 before and after nHFOV. Meanwhile, the changes in arterial blood pO2 and SpO2 were not significant. No complications associated with nHFOV were reported.

Conclusions: nHFOV is a safe and effective method for very preterm infants with RDS, facilitating CO2 elimination from the blood and reducing the O2 requirement.

Keywords: blood gas, nasal-high frequency oscillatory ventilation, preterm infants.

Abbreviation: nHFOV (nasal high-frequency oscillatory ventilation), RDS (respiratory distress syndrome), nCPAP (Nasal continuous positive airway pressure), BiPAP (Bilevel positive airway pressure), NIPPV (Noninvasive positive pressure ventilation)