J Korean Soc Neonatol.  2001 May;8(1):72-77.

Radiological Changes Following High Frequency Oscillatory Ventilation Therapy in Very Low Birth Weight Infants with Respiratory Distress Syndrome

• Pyeun YS
• Han BK
• Yoon HK
• Chang YS
• Park WS

Abstract

PURPOSE: High frequency oscillatory ventilation (HFOV) is used to support infants with severe respiratory failure unresponsive to conventional ventilation (CV). We reviewed chest radiographs before and after HFOV with clinical correlation in infants with respiratory distress syndrome (RDS).
METHODS
Eighteen very low birth weight infants with RDS who had HFOV were included in this study. All patients were diagnosed as having RDS clinically and radiologically. Mean gestational age of infants was 27 weeks (range : 24-31 weeks). The mean duration of HFOV was 3 days (range : 14 hours-9 days). The chest radiographs of these infants within 3 hours before and after application of HFOV were retrospectively reviewed. Radiological findings based on aeration and parenchymal densities were classified into improved, no change, and progressed. Medical records were reviewed for FiO2 levels, clinical outcomes, complications, and causes of death.
RESULTS
In 15 of 18 infants, aeration and parenchymal densities were improved and FiO2 levels were also improved after HFOV. Four of these 15 infants who showed improvement of radiological findings developed pneumothorax, sepsis, pulmonary or intestinal bleeding, and subsequently died. In remaining 3 infants in whom chest radiographs after HFOV showed no interval change or progression, oxygenation was also worsened and all died.
CONCLUSION
Chest radiographs of HFOV-treated, very low birth weight infants showed improvement of aeration and parenchymal densities in most cases. Clinical outcome was good in infants who showed improvement on chest radiographs compared to those of progression group as far as there was no associated complication. Knowledge of radiological changes after HFOV will help in interpretation of chest radiographs in those HFOV-treated infants.

Keyword

Very low birth weight infants; Respiratory distress syndrome; Radiologoc changes; High frequency oscillatory Ventilation

MeSH Terms

Cause of Death
Gestational Age
Hemorrhage
Humans
Infant*
Infant, Very Low Birth Weight*
Medical Records
Oxygen
Pneumothorax
Radiography, Thoracic
Respiratory Insufficiency
Retrospective Studies
Sepsis
Ventilation*
Oxygen