Table 2

Suggested parameters boundaries for NHFOV use in two clinical scenarios

PostextubationBPD-risk neonates
Paw (cmH2O)*8–1010–16
ΔP (cmH2O)†25–3530–50
Frequency (Hz)†10–128–10
  • Postextubation refers to infants within the first postnatal week, extubated from aggressive mechanical ventilation or with previously failed extubation attempts.

  • BPD-risk neonates refers to infants developing BPD, that is, having more than 1 week of postnatal age and still needing non-invasive ventilation with high pressure or oxygen requirements and/or with pending reintubation. These definitions and the ventilator parameters should be considered only as suggestion. Lung mechanics may vary in different patients and in different moments during the disease course: this may require adjustments of various parameters. Paw should be titrated on oxygenation, while ΔP and frequency should be titrated according to transcutaneous CO2 levels; visible chest oscillations may not be necessary to achieve adequate CO2 clearance. Different interfaces might also impact on the NHFOV performance and require parameters adjustments. IT should be fixed at 50%.

  • More details in the text.

  • *To be titrated according to oxygenation.

  • †To be titrated according to transcutaneous CO2 levels.

  • BPD, bronchopulmonary dysplasia; IT, inspiratory time; NHFOV, non-invasive high-frequency oscillatory ventilation.