High-frequency oscillatory ventilation with or without volume guarantee during neonatal transport

Abstract

Objectives To analyse and compare ventilator parameters during high-frequency oscillatory ventilation (HFOV) with or without volume guarantee (VG) in emergency neonatal transport. Study design: Data were downloaded with 0.5 Hz during transport, using a fabian™ HFOi ventilator over three years (n = 51), and analysed computationally. Results Median deviation of mean airway pressure from its target was < 1 cmH₂O. During HFOV (n = 26), the pressure amplitude differed from the target by < 1 cmH₂O. During HFOV-VG (n = 22), median deviation of the oscillation volume (VThf) from its target was − 0.07 mL/kg, but in some cases VThf was by > 0.38 mL/kg below target. Increasing the maximum allowed amplitude by 10 cmH₂O improved the maintenance of VThf. HFOV and HFOV-VG parameters were similar, except the lower amplitude during HFOV-VG. A VThf < 2.5 mL/kg avoided hypercapnia in most cases. Conclusions HFOV and HFOV-VG can be safely used during neonatal transport, maintaining ventilator parameters close to their targets.