A Successful Application of High-frequency Oscillation Ventilation in Extremely Severe Forms
of ARDS in Children
Pachl J.1, Brož L.2, Kripner J.2, Fric M.1, Roubík K.3, Zábrodský V.5, Waldauf P.1, Bakalář B.1, Vyhnánek F.4, Horáková O.1, Jandová J.1
Klinika anesteziologie a resuscitace, Fakultní nemocnice Královské Vinohrady a 3. LF UK, Praha1 přednosta doc. MUDr. J. Pachl, CSc. Klinika popáleninové medicíny, Fakultní nemocnice Královské Vinohrady a 3. LF UK, Praha2 přednosta MUDr. L. Brož Elektrotechnická fakulta ČVUT, Katedra radioelektroniky, Praha3 vedoucí prof. ing. F. Vejražka, CSc. Chirurgická klinika FN Královské Vinohrady a 3. LF UK, Praha4 přednosta doc. MUDr. J. Fanta, DrSc. Dětská klinika IPVZ a 1. LF UK, Fakultní Thomayerova nemocnice, Praha5 přednosta doc. MUDr. I. Novák, CSc. |
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Summary:
During the prospective observational clinical study of HFOV in adult ARDS (n = 30), two children (13 months
and 17 years of age) suffering from severe ARDS (oxygenation index OI = 75 and 50, respectively) underwent the
same therapeutical protocol. In the both cases the higher initial effective continuous distension pressure (CDP =
4.0 and 4.5 kPa) was used compared with the highest CDP valuess in adult group. HFOV with such high CDP
values led to improvement of oxygenation and circulatory parameters contrary to CMV period. Acceptable
oxygenation parameters with the use of fraction of inspired oxygen fraction F1O2 = 0.4 were achieved within 24
hours period, in one case also in combination with prone/supine positioning. The authors recommend to focus next
clinical trials to combined „HFOV/prone - supine“ therapeutical approach.
Key words:
high frequency oscillatory ventilation in children, paediatric ARDS, prone positioning, lung
contusion in children
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