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[PMID]:29214783
[Au] Autor:Lee SM; Namgung R; Eun HS; Lee SM; Park MS; Park KI
[Ad] Endereço:Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Effective Tidal Volume for Normocapnia in Very-Low-Birth-Weight Infants Using High-Frequency Oscillatory Ventilation.
[So] Source:Yonsei Med J;59(1):101-106, 2018 Jan.
[Is] ISSN:1976-2437
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Removal of CO2 is much efficient during high-frequency oscillatory ventilation (HFOV) for preterm infants. However, an optimal carbon dioxide diffusion coefficient (DCO2) and tidal volume (VT) have not yet been established due to much individual variance. This study aimed to analyze DCO2 values, VT, and minute volume in very-low-birth-weight (VLBW) infants using HFOV and correlates with plasma CO2 (pCO2). MATERIALS AND METHODS: Daily respiratory mechanics and ventilator settings from twenty VLBW infants and their two hundred seventeen results of blood gas analysis were collected. Patients were treated with the Dräger Babylog VN500 ventilator (Drägerwerk Ag & Co.) in HFOV mode. The normocapnia was indicated as pCO2 ranging from 45 mm Hg to 55 mm Hg. RESULTS: The measured VT was 1.7 mL/kg, minute volume was 0.7 mL/kg, and DCO2 was 43.5 mL²/s. Mean results of the blood gas test were as follows: pH, 7.31; pCO2, 52.6 mm Hg; and SpO2, 90.5%. In normocapnic state, the mean VT was significantly higher than in hypercapnic state (2.1±0.5 mL/kg vs. 1.6±0.3 mL/kg), and the mean DCO2 showed significant difference (68.4±32.7 mL²/s vs. 32.4±15.7 mL²/s). The DCO2 was significantly correlated with the pCO2 (p=0.024). In the receiver operating curve analysis, the estimated optimal cut-off point to predict the remaining normocapnic status was a VT of 1.75 mL/kg (sensitivity 73%, specificity 80%). CONCLUSION: In VLBW infants treated with HFOV, VT of 1.75 mL/kg is recommended for maintaining proper ventilation.
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Recém-Nascido de muito Baixo Peso/fisiologia
[Mh] Termos MeSH secundário: Gasometria
Dióxido de Carbono/análise
Feminino
Seres Humanos
Hipercapnia/fisiopatologia
Incidência
Lactente
Recém-Nascido
Masculino
Curva ROC
Volume de Ventilação Pulmonar
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.3349/ymj.2018.59.1.101


  2 / 1786 MEDLINE  
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[PMID]:29045215
[Au] Autor:Doyle LW; Ranganathan S; Cheong JLY
[Ad] Endereço:Royal Children's Hospital, Melbourne, VIC, Australia lwd@unimelb.edu.au.
[Ti] Título:Ventilation in Preterm Infants and Lung Function at 8 Years.
[So] Source:N Engl J Med;377(16):1601-1602, 2017 10 19.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Respiração
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Pulmão
Respiração Artificial
Síndrome do Desconforto Respiratório do Recém-Nascido
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711170


  3 / 1786 MEDLINE  
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[PMID]:29045214
[Au] Autor:Makhoul IR; Mashiach T; Smolkin T
[Ad] Endereço:Rambam Health Care Campus, Haifa, Israel makhoul.imad57@gmail.com.
[Ti] Título:Ventilation in Preterm Infants and Lung Function at 8 Years.
[So] Source:N Engl J Med;377(16):1600, 2017 10 19.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Respiração
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Pulmão
Respiração Artificial
Síndrome do Desconforto Respiratório do Recém-Nascido
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711170


  4 / 1786 MEDLINE  
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[PMID]:29045213
[Au] Autor:Vliegenthart RJ; Onland W; van Kaam AH
[Ad] Endereço:Academic Medical Center, Amsterdam, the Netherlands
[Ti] Título:Ventilation in Preterm Infants and Lung Function at 8 Years.
[So] Source:N Engl J Med;377(16):1600-1, 2017 10 19.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Respiração
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Pulmão
Respiração Artificial
Síndrome do Desconforto Respiratório do Recém-Nascido
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1711170


  5 / 1786 MEDLINE  
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Amato, Marcelo Britto Passos
Texto completo
[PMID]:28961282
[Au] Autor:Cordioli RL; Costa ELV; Azevedo LCP; Gomes S; Amato MBP; Park M
[Ad] Endereço:Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
[Ti] Título:Physiologic effects of alveolar recruitment and inspiratory pauses during moderately-high-frequency ventilation delivered by a conventional ventilator in a severe lung injury model.
[So] Source:PLoS One;12(9):e0185769, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: To investigate whether performing alveolar recruitment or adding inspiratory pauses could promote physiologic benefits (VT) during moderately-high-frequency positive pressure ventilation (MHFPPV) delivered by a conventional ventilator in a porcine model of severe acute respiratory distress syndrome (ARDS). METHODS: Prospective experimental laboratory study with eight pigs. Induction of acute lung injury with sequential pulmonary lavages and injurious ventilation was initially performed. Then, animals were ventilated on a conventional mechanical ventilator with a respiratory rate (RR) = 60 breaths/minute and PEEP titrated according to ARDS Network table. The first two steps consisted of a randomized order of inspiratory pauses of 10 and 30% of inspiratory time. In final step, we removed the inspiratory pause and titrated PEEP, after lung recruitment, with the aid of electrical impedance tomography. At each step, PaCO2 was allowed to stabilize between 57-63 mmHg for 30 minutes. RESULTS: The step with RR of 60 after lung recruitment had the highest PEEP when compared with all other steps (17 [16,19] vs 14 [10, 17]cmH2O), but had lower driving pressures (13 [13,11] vs 16 [14, 17]cmH2O), higher P/F ratios (212 [191,243] vs 141 [105, 184] mmHg), lower shunt (23 [20, 23] vs 32 [27, 49]%), lower dead space ventilation (10 [0, 15] vs 30 [20, 37]%), and a more homogeneous alveolar ventilation distribution. There were no detrimental effects in terms of lung mechanics, hemodynamics, or gas exchange. Neither the addition of inspiratory pauses or the alveolar recruitment maneuver followed by decremental PEEP titration resulted in further reductions in VT. CONCLUSIONS: During MHFPPV set with RR of 60 bpm delivered by a conventional ventilator in severe ARDS swine model, neither the inspiratory pauses or PEEP titration after recruitment maneuver allowed reduction of VT significantly, however the last strategy decreased driving pressures and improved both shunt and dead space.
[Mh] Termos MeSH primário: Modelos Animais de Doenças
Ventilação de Alta Frequência
Lesão Pulmonar/fisiopatologia
Alvéolos Pulmonares/fisiologia
[Mh] Termos MeSH secundário: Animais
Masculino
Estudos Prospectivos
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185769


  6 / 1786 MEDLINE  
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[PMID]:28646006
[Au] Autor:Carpi MF
[Ad] Endereço:Department of Pediatrics Botucatu Medical School UNESP - São Paulo State University Botucatu, São Paulo, Brazil mcarpi@fmb.unesp.br.
[Ti] Título:High-Frequency Jet Ventilation in Preterm Infants: Is There Still Room for It?
[So] Source:Respir Care;62(7):997-998, 2017 07.
[Is] ISSN:1943-3654
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ventilação em Jatos de Alta Frequência
Síndrome do Desconforto Respiratório do Recém-Nascido
[Mh] Termos MeSH secundário: Ventilação de Alta Frequência
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Respiração Artificial
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE
[do] DOI:10.4187/respcare.05647


  7 / 1786 MEDLINE  
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[PMID]:28506358
[Au] Autor:Huang J; Yuan L; Chen C
[Ad] Endereço:Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China. chen0610@163.com.
[Ti] Título:[Research advances in noninvasive high-frequency oscillatory ventilation in neonates].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(5):607-611, 2017 May.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure. Therefore, it is considered a new and effective noninvasive ventilation mode. There are many studies on the rational use, efficacy, and safety of noninvasive high-frequency oscillatory ventilation in neonates around the world. This article reviews the advances in the clinical studies on noninvasive high-frequency oscillatory ventilation in neonates.
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Ventilação não Invasiva
Insuficiência Respiratória/terapia
[Mh] Termos MeSH secundário: Ventilação de Alta Frequência/efeitos adversos
Seres Humanos
Recém-Nascido
Ventilação não Invasiva/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170517
[St] Status:MEDLINE


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[PMID]:28407831
[Au] Autor:Qiao JY; Li YZ; Wang HY; Zhang SD
[Ad] Endereço:Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. junying.qiao@163.com.
[Ti] Título:[A Meta analysis of the efficacy of high-frequency oscillatory ventilation versus conventional mechanical ventilation for treating pediatric acute respiratory distress syndrome].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(4):430-435, 2017 Apr.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To systematically assess the clinical efficacy of high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) for treating pediatric acute respiratory distress syndrome (ARDS). METHODS: Data from randomized controlled trials comparing HFOV and CMV in the treatment of pediatric ARDS published before July 2016 were collected from the Cochrane Library, PubMed, Medline, CNKI, and Wanfang Data. Literature screening, data extraction, and quality assessment were performed by two independent reviewers according to the inclusion and exclusion criteria. The selected studies were then subjected to a Meta analysis using the RevMan 5.3 software. RESULTS: A total of 6 studies involving 246 patients were included. The results of the Meta analysis showed that there were no significant differences between the HFOV and CMV groups in the in-hospital or 30-day mortality rate, incidence of barotrauma, mean ventilation time, and oxygenation index (P>0.05). However, compared with CMV, HFOV increased the PaO /FiO ratio by 17%, 24%, and 31% at 24, 48, and 72 hours after treatment respectively, and improved oxygenation in patients. CONCLUSIONS: Although the mortality rate is not reduced by HFOV in children with ARDS, this treatment can result in significant improvement in oxygenation compared with CMV. Further large-sample, multicenter, randomized clinical trials will be required to draw a definitive conclusion.
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Respiração Artificial
Síndrome do Desconforto Respiratório do Adulto/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Oxigênio/sangue
Síndrome do Desconforto Respiratório do Adulto/mortalidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE


  9 / 1786 MEDLINE  
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[PMID]:28273699
[Au] Autor:Wang CH; Shi LP; Ma XL; Lin HJ; Xu YP; Du LZ
[Ad] Endereço:Department of Neonatal Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310051, China.
[Ti] Título:[Use of noninvasive high-frequency oscillatory ventilation in very low birth weight infants].
[So] Source:Zhonghua Er Ke Za Zhi;55(3):177-181, 2017 Mar 02.
[Is] ISSN:0578-1310
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the effectiveness and safety of the use of noninvasive high-frequency oscillation ventilation (nHFOV) in very low birth weight infants. A total of 36 cases received nHFOV between January 2016 and October 2016 in Children's Hospital, Zhejiang University School of Medicine, including 24 males and 12 females, with the gestational age of (27.5±2.5) weeks and birth weight of(980±318)g. The data of the ventilator settings, side effects, and changes of the respiratory function before and after nHFOV were collected and analyzed retrospectively. Nonparametric tests or tests or χ(2) tests were used. Thirty-two (89%) out of the 36 cases successfully avoided intubation or re-intubation after using of nHFOV. nHFOV was used as the rescue treatment after failure of other noninvasive ventilation in 17 cases, and as the prophylactical treatment preventing re-intubation after extubation in the remaining 19 cases. There were significant decreases in the incidences of apnea and desaturation(SpO(2)<0.85), the level of PaCO(2, )and the FiO(2) 24 h after the initiation of the nHFOV as the rescue therapy((1.2±1.1) .(6.3±2.1)episodes , (1.1±1.2) .(4.3±1.5) episodes, (43±8) .(56±10) mmHg, 0.30±0.07 . 0.39±0.11, respectively; 1 mmHg=0.133 kPa, =7.562, 8.913, 4.179, 3.437 respectively, all <0.01). No significant changes were found in FiO(2) and PaCO(2) levels 24 h after initiation of nHFOV as the prophylactical therapy after extubation (0.42±0.12 .0.40±0.10, (49±8) .(48±7)mmHg, =0.872 and 0.501 respectively, both >0.05), except for the significant decreases in the mean airway pressure ((7.9±2.6) .(9.6±1.6)cmH(2)O, 1 cmH(2)0=0.098 kPa, =2.198, =0.041). There were 4 cases suffered from nasal septum injury, while no other nHFOV related complications were noted. nHFOV can be applied in preterm infants as a rescue treatment after the failure of other noninvasive ventilation, or prophylactically used in patients who have high risk of re-intubation.
[Mh] Termos MeSH primário: Ventilação de Alta Frequência
Recém-Nascido de muito Baixo Peso
[Mh] Termos MeSH secundário: Extubação
Peso ao Nascer
Feminino
Idade Gestacional
Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Ventilação não Invasiva
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1310.2017.03.003


  10 / 1786 MEDLINE  
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[PMID]:28245137
[Au] Autor:Meade MO; Young D; Hanna S; Zhou Q; Bachman TE; Bollen C; Slutsky AS; Lamb SE; Adhikari NKJ; Mentzelopoulos SD; Cook DJ; Sud S; Brower RG; Thompson BT; Shah S; Stenzler A; Guyatt G; Ferguson ND
[Ad] Endereço:1 Department of Medicine and.
[Ti] Título:Severity of Hypoxemia and Effect of High-Frequency Oscillatory Ventilation in Acute Respiratory Distress Syndrome.
[So] Source:Am J Respir Crit Care Med;196(6):727-733, 2017 Sep 15.
[Is] ISSN:1535-4970
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: High-frequency oscillatory ventilation (HFOV) is theoretically beneficial for lung protection, but the results of clinical trials are inconsistent, with study-level meta-analyses suggesting no significant effect on mortality. OBJECTIVES: The aim of this individual patient data meta-analysis was to identify acute respiratory distress syndrome (ARDS) patient subgroups with differential outcomes from HFOV. METHODS: After a comprehensive search for trials, two reviewers independently identified randomized trials comparing HFOV with conventional ventilation for adults with ARDS. Prespecified effect modifiers were tested using multivariable hierarchical logistic regression models, adjusting for important prognostic factors and clustering effects. MEASUREMENTS AND MAIN RESULTS: Data from 1,552 patients in four trials were analyzed, applying uniform definitions for study variables and outcomes. Patients had a mean baseline Pa /Fi of 114 ± 39 mm Hg; 40% had severe ARDS (Pa /Fi <100 mm Hg). Mortality at 30 days was 321 of 785 (40.9%) for HFOV patients versus 288 of 767 (37.6%) for control subjects (adjusted odds ratio, 1.17; 95% confidence interval, 0.94-1.46; P = 0.16). This treatment effect varied, however, depending on baseline severity of hypoxemia (P = 0.0003), with harm increasing with Pa /Fi among patients with mild-moderate ARDS, and the possibility of decreased mortality in patients with very severe ARDS. Compliance and body mass index did not modify the treatment effect. HFOV increased barotrauma risk compared with conventional ventilation (adjusted odds ratio, 1.75; 95% confidence interval, 1.04-2.96; P = 0.04). CONCLUSIONS: HFOV increases mortality for most patients with ARDS but may improve survival among patients with severe hypoxemia on conventional mechanical ventilation.
[Mh] Termos MeSH primário: Ventilação de Alta Frequência/métodos
Hipóxia/terapia
Respiração Artificial/métodos
Síndrome do Desconforto Respiratório do Adulto/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1164/rccm.201609-1938OC



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