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Neonatal Intensive
Care Unit, St James' University Hospital, Beckett Street, Leeds
LS9 7TF, UK
Correspondence to: Dr Morgan, Neonatal Intensive Care Unit, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, UK email: newells{at}sjuhnnu.demon.co.uk
Accepted 10 December 1999
AIMS
To describe the
relation between oscillatory amplitude changes and arterial blood gas
(ABG) changes in preterm infants receiving high frequency oscillatory
ventilation, using a multiparameter intra-arterial sensor (MPIAS).
METHODSContinuous
MPIAS ABG data were collected after amplitude changes and stratified
according to FIO2: high (> 0.4) or low
(< 0.3). For each amplitude change, the maximum change (from
baseline) in PaCO2 and
PaO2 over the following 30 minutes was
determined. In total, 64 oscillatory amplitude changes were measured in
21 infants (median birth weight 1040 g; gestation 27 weeks).
RESULTSAll amplitude
increases produced PaCO2 falls (median 
0.98
and 1.13 kPa for high and low FIO2 groups
respectively). All amplitude decreases produced
PaCO2 rises (median +0.94 and +1.24 kPa for high and low FIO2 groups respectively). About
95% of the change in PaCO2 was completed in 30 minutes. Amplitude changes did not affect PaO2
when FIO2 > 0.4. When
FIO2 < 0.3, amplitude increases produced a
PaO2 rise (median = +1.1 kPa; P < 0.001) and
amplitude decreases a fall (median = 1.2 kPa; P < 0.001).
CONCLUSIONSAfter
oscillatory amplitude changes, the speed but not the magnitude of the
PaCO2 change is predictable, and a rapid
PaO2 change accompanies the
PaCO2 change in infants with mild lung disease
and a low FIO2.
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