Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates
Background High-frequency oscillatory ventilation (HFOV) minimizes ventilator-induced lung injuries. Spontaneous sigh breathing may augment the functional residual capacity, increase lung compliance, and recruit atelectatic alveoli. Purpose To evaluate the difference in the partial pressure of carbo...
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The Korean Pediatric Society
2025-02-01
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| Series: | Clinical and Experimental Pediatrics |
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| Online Access: | http://www.e-cep.org/upload/pdf/cep-2024-01011.pdf |
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| author | Kulthida Baingam Anucha Thatrimontrichai Manapat Praditaukrit Gunlawadee Maneenil Supaporn Dissaneevate |
| author_facet | Kulthida Baingam Anucha Thatrimontrichai Manapat Praditaukrit Gunlawadee Maneenil Supaporn Dissaneevate |
| author_sort | Kulthida Baingam |
| collection | DOAJ |
| description | Background High-frequency oscillatory ventilation (HFOV) minimizes ventilator-induced lung injuries. Spontaneous sigh breathing may augment the functional residual capacity, increase lung compliance, and recruit atelectatic alveoli. Purpose To evaluate the difference in the partial pressure of carbon dioxide (PaCO2) in neonates receiving invasive HFOV as the primary mode of respiratory support before versus after sigh breaths (Sighs). Methods This prospective study was conducted between January and December 2023. Intubated preterm and term neonates who underwent HFOV with an available arterial line were enrolled in this study after informed parental consent was obtained. Sighs were set at a frequency of 3 breaths/min and pressure of 5 cmH2O above the mean airway pressure for 2 hours. Arterial blood gas was collected before and after Sighs and analyzed using 2 dependent tests. Results Thirty neonates with a mean gestational age of 33.6±4.1 weeks and median date of intervention of 1.88 days (interquartile range, 0.87–3.79 days) were enrolled. The mean PaCO2 level was significantly lower in the HFOV with Sighs group (45.2±6.6 mmHg) versus the HFOV alone group (48.8±3.1 mmHg) with a mean difference (MD) of -3.6 mmHg (95% confidence interval [CI], -6.3 to -0.9; P=0.01). Subgroup analyses indicated the ability of Sighs to reduce the PaCO2 level in neonates with respiratory distress syndrome (n=15; MD [95% CI]=-4.2 [-8.2 to -0.2] mmHg; P= 0.04). Conclusion Sighing can reduce PaCO2 levels in neonates ventilated with HFOV, particularly those with respiratory distress syndrome. |
| format | Article |
| id | doaj-art-5bbddb324d7c4281b6003c5b40c17da4 |
| institution | Kabale University |
| issn | 2713-4148 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | The Korean Pediatric Society |
| record_format | Article |
| series | Clinical and Experimental Pediatrics |
| spelling | doaj-art-5bbddb324d7c4281b6003c5b40c17da42025-02-07T07:38:40ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482025-02-0168217818410.3345/cep.2024.0101120125555754Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonatesKulthida Baingam0Anucha Thatrimontrichai1Manapat Praditaukrit2Gunlawadee Maneenil3Supaporn Dissaneevate4 Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, ThailandBackground High-frequency oscillatory ventilation (HFOV) minimizes ventilator-induced lung injuries. Spontaneous sigh breathing may augment the functional residual capacity, increase lung compliance, and recruit atelectatic alveoli. Purpose To evaluate the difference in the partial pressure of carbon dioxide (PaCO2) in neonates receiving invasive HFOV as the primary mode of respiratory support before versus after sigh breaths (Sighs). Methods This prospective study was conducted between January and December 2023. Intubated preterm and term neonates who underwent HFOV with an available arterial line were enrolled in this study after informed parental consent was obtained. Sighs were set at a frequency of 3 breaths/min and pressure of 5 cmH2O above the mean airway pressure for 2 hours. Arterial blood gas was collected before and after Sighs and analyzed using 2 dependent tests. Results Thirty neonates with a mean gestational age of 33.6±4.1 weeks and median date of intervention of 1.88 days (interquartile range, 0.87–3.79 days) were enrolled. The mean PaCO2 level was significantly lower in the HFOV with Sighs group (45.2±6.6 mmHg) versus the HFOV alone group (48.8±3.1 mmHg) with a mean difference (MD) of -3.6 mmHg (95% confidence interval [CI], -6.3 to -0.9; P=0.01). Subgroup analyses indicated the ability of Sighs to reduce the PaCO2 level in neonates with respiratory distress syndrome (n=15; MD [95% CI]=-4.2 [-8.2 to -0.2] mmHg; P= 0.04). Conclusion Sighing can reduce PaCO2 levels in neonates ventilated with HFOV, particularly those with respiratory distress syndrome.http://www.e-cep.org/upload/pdf/cep-2024-01011.pdfblood gas analysiscarbon dioxidehigh-frequency oscillation ventilationintermittent positive-pressure ventilationneonatal intensive care unitnewborn |
| spellingShingle | Kulthida Baingam Anucha Thatrimontrichai Manapat Praditaukrit Gunlawadee Maneenil Supaporn Dissaneevate Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates Clinical and Experimental Pediatrics blood gas analysis carbon dioxide high-frequency oscillation ventilation intermittent positive-pressure ventilation neonatal intensive care unit newborn |
| title | Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| title_full | Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| title_fullStr | Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| title_full_unstemmed | Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| title_short | Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| title_sort | effect of high frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates |
| topic | blood gas analysis carbon dioxide high-frequency oscillation ventilation intermittent positive-pressure ventilation neonatal intensive care unit newborn |
| url | http://www.e-cep.org/upload/pdf/cep-2024-01011.pdf |
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