Comparison Of High Frequency Oscillatory Ventilation And Conventional Mechanical Ventilation In The Treatment Of Neonatal Respiratory Failure

Objective To compare the clinical effect of high frequency oscillatoryventilation and conventional mechanical ventilation in the treatment ofneonatal respiratory failure.Methods Select112cases of children with respiratory failure fromOctober2011to December2013to our hospital neonatal intensive care unit(NICU) for treatment and were divided into high frequency oscillatoryventilation treatment group (HFOV group) and conventional mechanicalventilation treatment group (CMV group). Two groups of children weregiven high frequency oscillatory ventilation therapy and traditionalmechanical ventilation therapy on the basis of the same antibiotic resistanceto infection and nutrition support treatment. Observe the changes of meanarterial pressure, heart rate, oxygen partial pressure (PaO2), oxygensaturation (SaO2) and co2partial pressure (PaCO2), and other indicators oftwo group children before and after treatment. Compare the differences ofoxygen concentration (FiO2), oxygenationIndex(OI) and the artery of alveolar oxygen partial pressure ratio (a/A PaO2)after treatment6h,12h,24h, as well as the complications and outcome ofthe treatment. Results Mean arterial pressure and heart rate had no significant change(P>0.05) before and after High-frequency oscillatory ventilation andtraditional mechanical ventilation treatment for respiratory failure inchildren; Compared with before treatment, the oxygen partial pressure(PaO2) and oxygen saturation (SaO2) weresignificantly increased after treatment with high frequency oscillatoryventilation and mechanical ventilation, the difference was statisticallysignificant (P<0.05), and compared with the traditional mechanicalventilation therapy, application of high frequency oscillatory ventilationmade oxygen partial pressure (t=2.97, P<0.05) and oxygen saturation(t=2.66, P<0.05) increased more significantly, the difference has the obviousstatistical significance; Compared with before treatment, the co2partialpressure (PaCO2) were significantly reduced after treatment and hadstatistically significant difference (P<0.05). Compared with the traditionalmechanical ventilation therapy, application of high frequency oscillatoryventilation co2partial pressure decrease is more significant (t=4.5, P<0.05),the difference was statistically significant. Comparison with the effect ofapplication of high frequency oscillatory ventilation and traditionalmechanical ventilation on pulmonary oxygenation function ofrespiratory failure children found that the oxygen concentration (FiO2),oxygen index (OI) and arterial alveolar oxygen partial pressure ratio (a/APaO2) had no difference (P>0.05) before treatment; Compared with beforetreatment, the oxygen concentration (FiO2) reduced (P<0.05) aftertraditional mechanical ventilation therapy for6h, and the lower effect weremore significantly at12h,24h (P<0.05), rendering time dependence;Compared with before treatment, the reducing effect was more obvious afterhigh frequency oscillatory ventilation treatment (P<0.05), and comparedwith the traditional mechanical ventilation treatment group, the oxygen concentration(FiO2) were lower after treatment with the high frequencyoscillation ventilation at the same time,6h,12h,24h respectively were(t=5.04, P<0.05),(t=5.6, P<0.05),(t=6.84, P<0.05), the difference wasstatistically significant. Compared with before treatment, the oxygenationindex (OI) significantly decreased after6h (P<0.05) with traditionalmechanical ventilation therapy and12h,24h reduced more significantly(P<0.05), rendering time dependence; Compared with before treatment, thereducing effect was more obvious after high frequency oscillatoryventilation treatment (P<0.05), and compared with the traditionalmechanical ventilation treatment group, the oxygenation index (OI) werelower after treatment with the high frequency oscillation ventilation at thesame time,6h,12h,24h respectively were (t=3.35, P<0.05)(t=4.56,P<0.05),(t=5.41, P<0.05), the difference was statistically significant.Compared with before treatment, the artery alveolar oxygen partial pressureratio (a/A PaO2) significantly increased after6h (P<0.05) with traditionalmechanical ventilation therapy and12h,24h increasing more significantly(P<0.05), rendering time dependence; Compared with before treatment, theincreasing effect was more obvious after high frequency oscillatoryventilation treatment (P<0.05), and compared with the traditionalmechanical ventilation treatment group, the artery alveolar oxygen partialpressure ratio (a/A PaO2) were higher after treatment with the highfrequency oscillation ventilation at the same time,6h,12h,24hrespectively were (t=7.82, P<0.05),(t=3.69, P<0.05),(t=2.78, P<0.05) thedifference was statistically significant; High frequency oscillationventilation treatment group and the traditional mechanical ventilationtherapy group was no significant difference (P>0.05) in complicatedintracranial hemorrhage and ventilator associated pneumonia, but comparedthe traditional mechanical ventilation treatment group, high frequency oscillatory ventilation treatment group had significantly higher incidence ofpneumothorax (P<0.05) and high frequency oscillatory ventilation cure ratewas significantly higher than that of traditional mechanical ventilation,difference was statistically significant (P<0.05).Conclusion Compared with the traditional mechanical ventilation, highfrequency oscillatory ventilation can improve pulmonary ventilationand oxygenation function more apparently and obviously improve the curerate, reduce complications and mortality.