J Korean Med Sci.  2000 Apr;15(2):153-158. 10.3346/jkms.2000.15.2.153.

Comparison of respiratory indices in predicting response to high frequency oscillatory ventilation in very low birth weight infants with respiratory distress syndrome

• Ko SY
• Chang YS
• Park WS

• KMID: 648116
• DOI: http://doi.org/10.3346/jkms.2000.15.2.153

Abstract

To evaluate the predictive values of oxygenation index (OI), arterial-alveolar oxygen tension ratio (a/APO)2, and alveolar-arterial oxygen gradient ((A-a)DO2) for early recognition of responsiveness to high frequency oscillatory ventilation (HFOV) in very low birth weight infants with respiratory distress syndrome (RDS), 23 infants who received HFOV treatment for severe RDS after failing to be improved with conventional mechanical ventilation from July 1995 to February 1998 were included. Twelve infants survived with HFOV (Responder group), while 11 infants could not maintain oxygenation with HFOV and died (Non-responder group). Clinical record (of each patient) were retrospectively reviewed and compared with the respiratory indices. Mean (A-a)DO2 was significantly lower in the responder group than in the non-responder group at 2 hr after HFOV (p=0.024), and the difference was more remarkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2 hr after HFOV therapy was 100% in sensitivity and 80% in specificity. The earliest significant difference of mean a/APO2 between two groups was noted at 6 hr after HFOV treatment (p=0.019). OI showed no significant differences between two groups. In summary, (A-a)DO2 was the most effective and sensitive respiratory index for predicting the responsiveness to HFOV in infants with severe RDS providing due as early as 2 hr.

Keyword

High-Frequency Ventilation; Infant, Very Low Birth Weight; Respiratory Distress Syndrome

MeSH Terms

Comparative Study
High-Frequency Ventilation*
Human
Infant, Newborn
Infant, Very Low Birth Weight*
Oxygen/blood
Predictive Value of Tests
Prognosis
Pulmonary Gas Exchange*
Respiratory Distress Syndrome/therapy*
Respiratory Distress Syndrome/mortality
Respiratory Distress Syndrome/diagnosis*
Retrospective Studies
Sensitivity and Specificity
Treatment Outcome