High-frequency oscillation and paralysis stabilize surfactant protein-B-deficient infants

Erin L. King; Gary D. Shackelford; Aaron Hamvas

doi:10.1038/sj.jp.7210555

High-frequency oscillation and paralysis stabilize surfactant protein-B-deficient infants

Erin L. King, Gary D. Shackelford, Aaron Hamvas^*

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Objective: To determine if high-frequency oscillatory ventilation and neuromuscular blockade improve oxygenation and chest radiographic appearance more effectively than high-frequency oscillation alone for surfactant protein-B (SP-B)-deficient infants. Study Design: We reviewed medical records and chest radiographs of five SP-B-deficient infants awaiting lung transplantation. Changes in FiO₂ and radiographic scores were analyzed with respect to neuromuscular blockade status. Results: FiO₂ consistently increased 0.20 (SD 0.11) during high-frequency ventilation without neuromuscular blockade (p=0.02) and decreased 0.14 (SD 0.11) during high-frequency ventilation with neuromuscular blockade (p=0.05). Chest radiographic appearance, quantified by an expansion/aeration index, consistently deteriorated without neuromuscular blockade (p=0.01) and consistently improved with neuromuscular blockade (p=0.03). Changes in FiO₂ correlated with changes in radiograph scores (r=0.7, p < 0.001). Conclusions: High-frequency ventilation with neuromuscular blockade optimizes oxygenation for SP-B-deficient infants. This ventilatory strategy should be considered while awaiting the diagnosis of SP-B deficiency or lung transplantation.

Original language	English (US)
Pages (from-to)	421-425
Number of pages	5
Journal	Journal of Perinatology
Volume	21
Issue number	7
DOIs	https://doi.org/10.1038/sj.jp.7210555
State	Published - 2001

Funding

This study was supported in part by National Institutes of Health HL/HD54187 (A.H.). An abstract based on these data was presented at the American Thoracic Society International Conference, 16 – 21 May 1997, San Francisco, CA ( Am J Respir Crit Care Med 1997;155:A236 ).

ASJC Scopus subject areas

Obstetrics and Gynecology
Pediatrics, Perinatology, and Child Health

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title = "High-frequency oscillation and paralysis stabilize surfactant protein-B-deficient infants",

abstract = "Objective: To determine if high-frequency oscillatory ventilation and neuromuscular blockade improve oxygenation and chest radiographic appearance more effectively than high-frequency oscillation alone for surfactant protein-B (SP-B)-deficient infants. Study Design: We reviewed medical records and chest radiographs of five SP-B-deficient infants awaiting lung transplantation. Changes in FiO2 and radiographic scores were analyzed with respect to neuromuscular blockade status. Results: FiO2 consistently increased 0.20 (SD 0.11) during high-frequency ventilation without neuromuscular blockade (p=0.02) and decreased 0.14 (SD 0.11) during high-frequency ventilation with neuromuscular blockade (p=0.05). Chest radiographic appearance, quantified by an expansion/aeration index, consistently deteriorated without neuromuscular blockade (p=0.01) and consistently improved with neuromuscular blockade (p=0.03). Changes in FiO2 correlated with changes in radiograph scores (r=0.7, p < 0.001). Conclusions: High-frequency ventilation with neuromuscular blockade optimizes oxygenation for SP-B-deficient infants. This ventilatory strategy should be considered while awaiting the diagnosis of SP-B deficiency or lung transplantation.",

author = "King, {Erin L.} and Shackelford, {Gary D.} and Aaron Hamvas",

note = "Funding Information: This study was supported in part by National Institutes of Health HL/HD54187 (A.H.). An abstract based on these data was presented at the American Thoracic Society International Conference, 16 – 21 May 1997, San Francisco, CA ( Am J Respir Crit Care Med 1997;155:A236 ).",

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AU - Shackelford, Gary D.

AU - Hamvas, Aaron

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PY - 2001

Y1 - 2001

N2 - Objective: To determine if high-frequency oscillatory ventilation and neuromuscular blockade improve oxygenation and chest radiographic appearance more effectively than high-frequency oscillation alone for surfactant protein-B (SP-B)-deficient infants. Study Design: We reviewed medical records and chest radiographs of five SP-B-deficient infants awaiting lung transplantation. Changes in FiO2 and radiographic scores were analyzed with respect to neuromuscular blockade status. Results: FiO2 consistently increased 0.20 (SD 0.11) during high-frequency ventilation without neuromuscular blockade (p=0.02) and decreased 0.14 (SD 0.11) during high-frequency ventilation with neuromuscular blockade (p=0.05). Chest radiographic appearance, quantified by an expansion/aeration index, consistently deteriorated without neuromuscular blockade (p=0.01) and consistently improved with neuromuscular blockade (p=0.03). Changes in FiO2 correlated with changes in radiograph scores (r=0.7, p < 0.001). Conclusions: High-frequency ventilation with neuromuscular blockade optimizes oxygenation for SP-B-deficient infants. This ventilatory strategy should be considered while awaiting the diagnosis of SP-B deficiency or lung transplantation.

AB - Objective: To determine if high-frequency oscillatory ventilation and neuromuscular blockade improve oxygenation and chest radiographic appearance more effectively than high-frequency oscillation alone for surfactant protein-B (SP-B)-deficient infants. Study Design: We reviewed medical records and chest radiographs of five SP-B-deficient infants awaiting lung transplantation. Changes in FiO2 and radiographic scores were analyzed with respect to neuromuscular blockade status. Results: FiO2 consistently increased 0.20 (SD 0.11) during high-frequency ventilation without neuromuscular blockade (p=0.02) and decreased 0.14 (SD 0.11) during high-frequency ventilation with neuromuscular blockade (p=0.05). Chest radiographic appearance, quantified by an expansion/aeration index, consistently deteriorated without neuromuscular blockade (p=0.01) and consistently improved with neuromuscular blockade (p=0.03). Changes in FiO2 correlated with changes in radiograph scores (r=0.7, p < 0.001). Conclusions: High-frequency ventilation with neuromuscular blockade optimizes oxygenation for SP-B-deficient infants. This ventilatory strategy should be considered while awaiting the diagnosis of SP-B deficiency or lung transplantation.

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High-frequency oscillation and paralysis stabilize surfactant protein-B-deficient infants

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