European Journal of Pediatrics

, Volume 174, Issue 4, pp 465–471

Nasal high-frequency oscillation ventilation in neonates: a survey in five European countries

  • Hendrik Stefan Fischer
  • Kajsa Bohlin
  • Christoph Bührer
  • Gerd Schmalisch
  • Malte Cremer
  • Irwin Reiss
  • Christoph Czernik
Original Article

DOI: 10.1007/s00431-014-2419-y

Cite this article as:
Fischer, H.S., Bohlin, K., Bührer, C. et al. Eur J Pediatr (2015) 174: 465. doi:10.1007/s00431-014-2419-y

Abstract

Nasal high-frequency oscillation ventilation (nHFOV) is a non-invasive ventilation mode that applies an oscillatory pressure waveform to the airways using a nasal interface. nHFOV has been shown to facilitate carbon dioxide expiration, but little is known about its use in neonates. In a questionnaire-based survey, we assessed nHFOV use in neonatal intensive care units (NICUs) in Austria, Switzerland, Germany, the Netherlands, and Sweden. Questions included indications for nHFOV, equipment used, ventilator settings, and observed side effects. Of the clinical directors of 186 NICUs contacted, 172 (92 %) participated. Among those responding, 30/172 (17 %) used nHFOV, most frequently in premature infants <1500 g (27/30) for the indication nasal continuous positive airway pressure (nCPAP) failure (27/30). Binasal prongs (22/30) were the most common interfaces. The median (range) mean airway pressure when starting nHFOV was 8 (6–12) cm H2O, and the maximum mean airway pressure was 10 (7–18) cm H2O. The nHFOV frequency was 10 (6–13) Hz. Abdominal distension (11/30), upper airway obstruction due to secretions (8/30), and highly viscous secretions (7/30) were the most common nHFOV side effects.

Conclusion: In a number of European NICUs, clinicians use nHFOV. The present survey identified differences in nHFOV equipment, indications, and settings. Controlled clinical trials are needed to investigate the efficacy and side effects of nHFOV in neonates.

Keywords

High-frequency oscillation Non-invasive ventilation Continuous positive airway pressure Side effects Neonate Survey 

Abbreviations

BPD

Bronchopulmonary dysplasia

HFOV

High-frequency oscillation ventilation

nCPAP

Nasal continuous positive airway pressure

nHFOV

Nasal high-frequency oscillation ventilation

NICU

Neonatal intensive care unit

nIPPV

Nasal intermittent positive pressure ventilation

Pmean

Mean pressure

RDS

Respiratory distress syndrome

VLBW

Very low birth weight infant

Supplementary material

431_2014_2419_MOESM1_ESM.pdf (15 kb)
Online Resource 1(PDF 14 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hendrik Stefan Fischer
    • 1
  • Kajsa Bohlin
    • 2
  • Christoph Bührer
    • 1
  • Gerd Schmalisch
    • 1
  • Malte Cremer
    • 1
  • Irwin Reiss
    • 3
  • Christoph Czernik
    • 1
  1. 1.Department of NeonatologyCharité Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of NeonatologyKarolinska University Hospital Huddinge and Karolinska InstitutetStockholmSweden
  3. 3.Department of NeonatologyErasmus Medisch Centrum RotterdamRotterdamThe Netherlands

Personalised recommendations