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.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Obstetrics and Gynecology