Noninvasive High-Frequency Oscillation Ventilation in preterm infants with respiratory failure: A Retrospective Cohort Study

Abstract Objective :Noninvasive high-frequency oscillatory ventilation (nHFOV) is a relatively new non-invasive modality, and evidence for its use is limited. This study aimed to investigate the feasibility of nHFOV in preventing reintubation in premature newborn infants. Methods: This study retrospectively analyzed the clinical data of 101 premature infants with RDS who were treated in our hospital from between November 2017 and November 2020. The inclusion criteria were premature infants born in our hospital who need nHFOV for more than 24 hours, and the exclusion criteria were who do not need nHFOV or whose duration of NHFOV was less than 24 hours. Results :101 preterm infants (birth weight:995±244g，gestational age:27±1 weeks) were commenced on receive NHFOV treatment on 116 occasions. NHFOV was used immediately postextubation as next level of noninvasive respiratory support (prophylaxis)in 78 of 116 occasions and as“rescue”(NCPAP or biphasic CPAP failed) in 36 of 116 occasions. Treatment with NHFOV was successful in 100 occasions (86%) while 16 occasions (14%) were needed to be intubated within 7 days. Percutaneous oxygen saturation was improved after noninvasive high-frequency ventilation( the groups of 86-90% and 91-95%, p=0.00), suggesting better oxygenation and reducing apnea(0.9±0.9 vs 0.5±0.5,p=0.00).In terms of carbon dioxide emissions, PCO2 was significantly different before and after ventilation in the rescue group((54.9±15.1 vs 42.6±8.8, p=0.00), but not in the prophylaxis group(45.1±10.9 vs 44.9±9.1, p=0.97).There was no difference in FiO2(%) requirements before and after starting NHFOV (35.5±8.8 vs 33.8±9.0, p=0.17, respectively) . Conclusion The use of NHFOV is feasible as a prophylactic or rescue mode of NIV, which decreases the number of apneas and PCO2. it is worthy of further clinical application research.