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

To analyse deviation of ventilator parameters from their set targets during high-frequency oscillatory ventilation (HFOV) with or without volume guarantee (VG) and compare the two modes during emergency neonatal transport.

Retrospective observational study using the fabian™ HFOi ventilator.

Median deviation of mean airway pressure from the set value was <1 cmH₂O. During HFOV the pressure amplitude differed from the set value by <1 cmH₂O. During HFOV-VG median deviation of the oscillation volume (VThf) from the targeted value was −0.07 mL/kg, but in some cases VThf was by >0.38 mL/kg below target. Setting maximum allowed amplitude 10 cmH₂O above the usually required amplitude improved maintenance of VThf. HFOV and HFOV-VG parameters were similar, except the lower amplitude during HFOV without VG. VThf <2.5 mL/kg avoided hypercapnia in most cases.

HFOV and HFOV-VG maintain ventilator parameters close to their targets and are promising modalities during neonatal transport.