• P N McDougall, P M Loughnan, N T Campbell, M Hochmann, B J Timms, and W W Butt.
• Department of Neonatology, Royal Children's Hospital, Parkville, Victoria, Australia.
• J Paediatr Child Health. 1995 Aug 1; 31 (4): 292-6.

ObjectiveTo report ventilation strategies, survival and complications in 39 outborn infants treated with high frequency oscillatory ventilation (HFOV).MethodologyData were collected prospectively between 1 May 1992 and 31 December 1993 on all infants treated with HFOV who had severe respiratory failure despite optimal conventional ventilation.ResultsTwenty-eight out of 39 (72%) survived. Of the 15 infants with birthweights < 1500 g, eight survived. Best survival rates were for infants with pulmonary interstitial emphysema with air leak (4/5) and for infants of birthweight > 1500 g with hyaline membrane disease (8/8), and meconium aspiration syndrome (7/7). Three infants deteriorated while on HFOV and required extracorporeal membrane oxygenation. Complications were: (i) development of pulmonary interstitial emphysema (1); (ii) recurrence of pneumothorax (3); (iii) hypotension (2); and (iv) bronchopulmonary dysplasia (9). One of the eight infants weighing < 1500 g who received HFOV in the first week of life developed periventricular haemorrhage.ConclusionThe initial results of HFOV for severe failure were encouraging although a learning curve was encountered with its introduction.

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