Title: Nasal high frequency ventilation in neonates with moderate respiratory insufficiency
Abstract: <h3>AIM</h3> To investigate the efficacy of nasal high frequency ventilation (nHFV) in newborn infants with moderate respiratory insufficiency. <h3>METHOD</h3> Twenty one preterm and term neonates were treated with nHFV for respiratory insufficiency. Criteria for starting nHFV were: deterioration on nasal CPAP expressed by a median pH of 7.24 and pCO<sub>2</sub> of 8.3 kPa, or increasing FIO<sub>2</sub>. nHFV was delivered using the Infant Star ventilator. Ventilator setting amplitude was 35 cm H<sub>2</sub>O; mean airway pressure 7 cm H<sub>2</sub>O; and frequency 10 Hz. <h3>RESULTS</h3> pCO<sub>2</sub>decreased significantly from 8.3 kPa to 7.2 kPa after nHFV was started. In five patients nHFV was discontinued after a median period of 6½ hours due to CO<sub>2</sub> retention and high oxygen need, and endotracheal mechanical ventilation was started. <h3>CONCLUSIONS</h3> nHFV can reduce pCO<sub>2</sub> in neonates with moderate respiratory insufficiency and, therefore, could be used to decrease the need for endotracheal mechanical ventilation.