Regular Lung Recruitment Maneuvers During High-frequency Oscillatory Ventilation in Extremely Preterm Infants: a Randomized Controlled Trial

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2022 Dec 12

PMID 36503480

Authors

Tobias Werther

Erik Kueng

Lukas Aichhorn

Linda Pummer

Katharina Goeral

Angelika Berger

Michael Hermon

Katrin Klebermass-Schrehof

Affiliations

Soon will be listed here.

Abstract

Background: Lung recruitment maneuvers (LRMs) improve lung volume at initiation of high-frequency oscillatory ventilation (HFOV), but it is unclear when to repeat LRMs. We evaluated the efficiency of scheduled LRMs.

Methods: In a randomized controlled trial, extremely preterm infants on HFOV received either LRMs at 12-hour intervals and when clinically indicated (intervention) or only when clinically indicated (control). The primary outcome was the cumulative oxygen saturation index (OSI) over HFOV time, limited to 7 days. Additionally, LRMs were analyzed with respect to OSI improvement.

Results: Fifteen infants were included in each group. The mean (SD) postmenstrual age and weight at HFOV start were 23 + 6 (0 + 5) weeks and 650 (115) g in the intervention group and 24 + 4 (0 + 6) weeks (p = 0.03) and 615 (95) g (p = 0.38) in the control group. The mean (SD) cumulative OSI amounted to 4.95 (1.72) in the intervention versus 5.30 (2.08) in the control group (p = 0.61). The mean (SD) number of LRMs in 12 h was 1.3 (0.2) in the intervention versus 1.1 (0.5) in the control group (p = 0.13). Performing LRM when FiO2 > 0.6 resulted in a mean OSI reduction of 3.6.

Conclusion: Regular versus clinically indicated LRMs were performed with equal frequency in preterm infants during HFOV, and consequently, no difference in lung volume was observed. LRMs seem to be most efficient at high FiO2.

Trial Registration: ClinicalTrials.gov ID: NCT04289324 (28/02/2020).

Citing Articles

Premature Infants Show Consistently Good Lung Compliance During Conventional Mechanical Ventilation.

Reiss A, Lauth W, Wald M Pediatr Pulmonol. 2024; 60(1):e27419.

PMID: 39620379 PMC: 11748114. DOI: 10.1002/ppul.27419.

Oscillometry for personalizing continuous distending pressure maneuvers: an observational study in extremely preterm infants.

Veneroni C, Dellaca R, Kung E, Bonomi B, Berger A, Werther T Respir Res. 2024; 25(1):4.

PMID: 38178216 PMC: 10765834. DOI: 10.1186/s12931-023-02639-4.

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