Nasal high frequency ventilation in neonates with moderate respiratory insufficiency.

AIM To investigate the efficacy of nasal high frequency ventilation (nHFV) in newborn infants with moderate respiratory insufficiency. METHOD Twenty one preterm and term neonates were treated with nHFV for respiratory insufficiency. Criteria for starting nHFV were: deterioration on nasal CPAP expressed by a median pH of 7.24 and pCO2 of 8.3 kPa, or increasing FIO2. nHFV was delivered using the Infant Star ventilator. Ventilator setting amplitude was 35 cm H2O; mean airway pressure 7 cm H2O; and frequency 10 Hz. RESULTS pCO2 decreased significantly from 8.3 kPa to 7.2 kPa after nHFV was started. In five patients nHFV was discontinued after a median period of 6 1/2 hours due to CO2 retention and high oxygen need, and endotracheal mechanical ventilation was started. CONCLUSIONS nHFV can reduce pCO2 in neonates with moderate respiratory insufficiency and, therefore, could be used to decrease the need for endotracheal mechanical ventilation.