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High frequency oscillatory ventilation in infants with increased intra-abdominal pressure
  1. Tai Fai Fok,
  2. Pak Cheung Ng,
  3. William Wong,
  4. Cheuk Hon Lee,
  5. King Woon So
  1. Department of Paediatrics, the Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
  1. Dr TF Fok.

Abstract

AIMS To describe the short term effect of high frequency oscillatory ventilation on infants with severe abdominal distension who could not be conventionally ventilated.

METHODS Eight infants (25 to 38 gestational weeks, birthweight 600-3200 g, postnatal age 1 to 190 days) with a variety of intra-abdominal pathologies, resulting in severe abdominal distension and failure of conventional ventilation, were studied.

RESULTS The oxygenation status of all infants significantly improved within an hour of changing from conventional to high frequency oscillatory ventilation. Infants who were hypercapneic on conventional ventilation also showed a reduction in PaCO2. As a group, the mean (SD) PaO2/FIO2 improved from 4.99 (0.98) kpa to 11.55 (3.8) kpa (P = 0.002), and the PaCO2 from 6.48 (2.12) kpa to 4.89 (1.22) kpa (P= 0.028). These improvements were sustained throughout the next 48 hours.

CONCLUSION High frequency oscillatory ventilation seems to be an effective rescue measure for infants with respiratory failure secondary to increased intra-abdominal pressure.

  • abdominal distension
  • high frequency oscillatory ventilation
  • respiratory failure.
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