Volume delivery during high frequency oscillation
a Children Nationwide Regional Neonatal
Intensive Care Centre, King's College Hospital, London, b Department of Paediatrics, United Medical and Dental Schools,
St Thomas' Hospital, London
Correspondence to: Professor A Greenough, Children Nationwide Regional Neonatal Intensive Care Centre, 4th floor, Ruskin Wing, King's College Hospital, London SE5 9RS.
Accepted 24
September 1997
AIM
To examine the delivered volume during "high
volume strategy" high frequency oscillation, used as rescue treatment
in preterm infants; and to identify factors, other than frequency and
oscillatory amplitude, influencing the magnitude of volume delivery.
METHODTwenty infants (median
gestational age 29 weeks) were studied on 45 occasions. Two
oscillator types were used (SensorMedics and SLE). Delivered volume was
measured under clinical conditions with the arterial blood gases within
a predetermined range. A specially calibrated pneumotachograph system
was used.
RESULTSOverall, the median delivered volume was
2.4 ml/kg (range 1.0 to 3.6 ml/kg); on 32 occasions the delivered
volume was greater than 2.0 ml/kg and on seven greater than 3.0 ml/kg.
The delivered volume related significantly to disease severity; there
was an inverse correlation between delivered volume and both the
oxygenation index (OI) (r=
0.51) and AaDO2 (r=0.54).
CONCLUSIONDelivered volume during HFO may, in
certain infants, exceed the anatomical dead space, permitting some
direct alveolar ventilation.
© 1998 by Archives of Disease in Childhood
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