Use of high frequency oscillatory ventilator in neonates with respiratory failure: the clinical practice in Taiwan and early multimodal outcome prediction

High-frequency oscillatory ventilation (HFOV) can be a rescue for neonates with refractory respiratory failure or an early elective therapy for preterm infants with severe respiratory distress syndrome (RDS). However, little is known about the current evolution and therapeutic limitations of HFOV. W...

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Bibliographic Details
Published in:Scientific reports 2020-04, Vol.10 (1), p.6603-6603, Article 6603
Main Authors: Yang, Mei-Chin, Hsu, Jen-Fu, Hsiao, Hsiu-Feng, Yang, Lan-Yan, Pan, Yu-Bin, Lai, Mei-Yin, Chu, Shih-Ming, Huang, Hsuan-Rong, Chiang, Ming-Chou, Fu, Ren-Huei, Tsai, Ming-Horng
Format: Article
Language:English
Subjects:
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Clinical medicine
Female
High-Frequency Ventilation - instrumentation
Humanities and Social Sciences
Humans
Infant, Newborn
Infants
Intensive Care Units
Kaplan-Meier Estimate
Male
Mechanical ventilation
Mortality
multidisciplinary
Neonates
Oxygenation
Patients
Practice Patterns, Physicians
Respiratory distress syndrome
Respiratory failure
Respiratory Insufficiency - mortality
Respiratory Insufficiency - therapy
Respiratory therapy
Risk Factors
ROC Curve
Science
Science (multidisciplinary)
Taiwan
Treatment Outcome
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Summary:High-frequency oscillatory ventilation (HFOV) can be a rescue for neonates with refractory respiratory failure or an early elective therapy for preterm infants with severe respiratory distress syndrome (RDS). However, little is known about the current evolution and therapeutic limitations of HFOV. We therefore aimed to describe its use in clinical practice and predict the risk of mortality for neonates receiving HFOV. A retrospective observational study of all neonates treated with HFOV in a quaternary referral NICU between January 2007 and December 2016 was conducted. We classified these patients into five subgroups based on primary respiratory diagnoses. We performed the logistic regression and decision tree regression analyses to identify independent factors of 30-day mortality following HFOV. A total of 1125 patients who were ever supported on HFOV were enrolled, of whom 64.1% received HFOV as a rescue therapy, 27.2% received it as an elective therapy, and 8.7% received it for air leak. An average oxygenation index (OI) greater than 25 in the first 24 hours after the initiation of HFOV and patients with secondary pulmonary hypertension were found to have the greatest risk of in-hospital mortality (p 
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-63655-8