Tanyah

Dear All As the application specialist for Dräger in Neonatal Ventilation in South Africa, perhaps if I could suggest Prof. Jane Pillow’s book on HFOV where the A-Z on HFOV is addressed. There are also various online webinars where Prof. Jane Pillow discusses HFOV including HFOV + VG. Extremely important with HFOV is that the set Amplitude is achieved at patient end which can only be measured if using the proximal flow sensor during HFOV. The monitored patient values should include the patient realized Delta Pressure if the set amplitude and measured delta pressure are not equal, blood gas result will reflect minimal changes in response to hertz changes, and in the event of VG it is highly likely that tidal volumes will also not be achieved. The hertz and I:E of HFO (or Ti) need to be adjusted until delta pressure is achieved at patient. This will influence tidal volume and thus CO2. VG regulates the the amplitude according to changes in lung compliance and or resistance changes. Compliance changes will directly influence the tidal volume and hence the set TV may not be achieved and the ventilator will give the message that tidal volume is then not achieved. Trouble shooting would include eliminating reason for a change in lung compliance and/ or resistance and if possible increase amplitude max or changing I:E ratio and hertz. Monitoring of the DCO2 value gives additional information with regards to CO2. The DCO2 is a calculated value and is inversely proportionate to CO2, hence if CO2 is on the increase the DCO2 value will drop, and visa versa. I hope this will be of assistance in the future during HFOV. Best Regards