ĐẶC ĐIỂM TRẺ SƠ SINH ĐƯỢC THỞ MÁY RUNG TẦN SỐ CAO TẠI BỆNH VIỆN NHI ĐỒNG THÀNH PHỐ

Abstract

Background: Respiratory failure remains the most common cause of neonatal mortality, particularly among preterm infants. High-frequency oscillatory ventilation (HFOV) is an invasive respiratory support strategy used as a rescue therapy or early alternative to conventional mechanical ventilation (CMV) in severe respiratory failure. Objectives: To describe HFOV intervention characteristics, evaluate changes in respiratory and hemodynamic parameters before and after HFOV, and survival outcomes in neonates receiving HFOV at City Children's Hospital. Methods: A prospective cohort study was conducted from July 2024 to July 2025 at the Neonatal Intensive Care Unit of City Children's Hospital. Results: A total of 73 newborns with respiratory failure received HFOV. Mean gestational age was 32.9 ±  0.6  weeks and a mean birth weight was 2046.1 ±  120.8 gram. The primary diagnoses included respiratory distress syndrome (35.6%), pneumonia (20.5%), and congenital diaphragmatic hernia (20.5%). After HFOV initiation, significant improvements were observed: PaCO₂ decreased from 55.3 to 42.6 mmHg, pH increased from 7.21 to 7.29, and PaO₂/FiO₂ ratio increased from 85.7 to 215.7, the difference was statistically significant, p < 0.001. Mean blood pressure increased from 40.4 to 45.5 mmHg, and cardiac output also improved significantly (left ventricular output (LVO) +53.7 ml/kg/min, right ventricular output (RVO) +97.7 ml/kg/min), the difference was statistically significant, p < 0.001. The 30-day survival rate was 79.5%, and survival to hospital discharge was 56.2%. Conclusion: High-frequency oscillatory ventilation effectively improves ventilation, oxygenation, and hemodynamic stability, contributing to increased survival in neonates with severe respiratory failure unresponsive to or requiring high settings on conventional mechanical ventilation