In your practice, is there a place now for elective HFOV for VLBW infants with severe RDS?

No, we are not using elective HFOV in VLBW infants with RDS but are using it when there are air leaks associated with HMD or the conventional ventilation fails. Pulmonary Haemorrhage is another indication for its use.

No, we are not using elective HFOV in VLBW infants with RDS but are using it when there are air leaks associated with HMD or the conventional ventilation fails. Pulmonary Haemorrhage is another indication for its use.

If you say so clearly that HFOV is good for catastrophies ,why not use it from the very beginnig , and may be preventing these situations.

Avi Rotschild

In your practice, is there a place now for elective HFOV for VLBW infants with severe RDS?

Dear Sir:

I feel that "NO" answer is to far from Evidence based medicine as HFOV proven practicaly and evidince based medicine as equaql as CMV, many centers, many units are using the elective as thier data support better respiratory outcome.

Husam Salama

Most infants in our units that are less than 32 weeks, have received Infasurf, and still require mechanical ventilation are placed on a HFOV. We have seen a decrease in BPD/Chronic lung disease of about 50% from previous levels. We also frequently use HFOV in infants of any gestational age that are not responding to SIMV (synchronized intermittent mandatory ventilation) with good result.

If I understood correctly, the question was about newborn with severe forms of RDS (OI is more than 12). We are should talking about the application of serious parameters of conventional mechanical ventilation. In traditional ventilation machines can be difficult to list low levels to prevent respiratory volumtrauma. Therefore, I think HFOV is a good choice for these patients.

In our Tunisian PICU, especially at the children's hospital, i think that we have a very good experience with HFOV in different situation (respiratory failure of the term and near term newborn, in infants and child and in preterm infants). for many yeras, exogenous Surfactant was not used for financial reasons (?), so we ventilated our preterm patients frequently by HFOV with an early rescue use and sometimes as elective use. I think that we had no problem in term of complication particulary in neurological one. Since a few years, we use surfactant as soon as possible and use of HFOV had been a rare event. we think that using HFOV electively before Surfactant therapy is not recommended especially where you read recent papers of meta-analysis (Thome +++++).