Effects of pressure support ventilation plus volume guarantee vs. high-frequency oscillatory ventilation on lung inflammation in preterm infants

Pediatr Pulmonol. 2006 Mar;41(3):242-9. doi: 10.1002/ppul.20350.

Abstract

The aim of the present study was to evaluate if high-frequency oscillatory ventilation (HFOV) might reduce lung inflammation in preterm infants with infant respiratory distress syndrome (RDS) in comparison with the early application of another potentially lung-protective ventilation strategy, such as pressure support ventilation plus volume guarantee (PSV + VG). Infants at less than 30 weeks of gestation with RDS were enrolled consecutively in the study if they required mechanical ventilation, and were randomly allocated to receive HFOV or PSV + VG. Bronchial aspirate samples for the measurement of interleukin (IL)-1beta, IL-8, and IL-10 were obtained before surfactant treatment (T1), after 6-18 hr of ventilation (T2), after 24-48 hr of ventilation (T3), and before extubation (T4). Thirteen patients were enrolled in the HFOV group, and 12 in the PSV + VG group. The mean values of IL-1beta, IL-8, and IL-10 at T4 were lower in the HFOV group than in the PSV + VG group. The present study demonstrates that early treatment with HFOV is associated with a reduction of lung inflammation in comparison with PSV + VG in preterm infants with RDS.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Bronchoalveolar Lavage Fluid / chemistry
  • Bronchopulmonary Dysplasia / diagnosis
  • Bronchopulmonary Dysplasia / mortality
  • Bronchopulmonary Dysplasia / therapy*
  • Cytokines / analysis*
  • Female
  • Follow-Up Studies
  • High-Frequency Ventilation / adverse effects
  • High-Frequency Ventilation / methods*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Inflammation / physiopathology
  • Inflammation / prevention & control
  • Inflammation Mediators / analysis
  • Male
  • Positive-Pressure Respiration / methods*
  • Probability
  • Prospective Studies
  • Respiratory Distress Syndrome, Newborn / diagnosis
  • Respiratory Distress Syndrome, Newborn / mortality
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Respiratory Function Tests
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome

Substances

  • Cytokines
  • Inflammation Mediators