TITLE:
Carbon Dioxide Levels When Starting High Frequency Ventilation in Neonates
AUTHORS:
Jany Pienaar, Mark W. Davies
KEYWORDS:
Infant, Newborn, High-Frequency Ventilation, Carbon Dioxide
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.2,
May
11,
2022
ABSTRACT: Objective: High-frequency ventilation (HFV) is an effective means to achieve gas
exchange in neonates. Adequate carbon dioxide (pCO2) levels are best
achieved immediately after starting HFV, avoiding either hypercapnia or hypocapnia. We aimed to
determine the initial pCO2 levels after starting HFV, and the time
taken to obtain the initial blood gas. Methods: We conducted an
observational retrospective study on neonates that required their first episode
of HFV. Data included the first blood gas result after starting HFV and when
the gas was taken after starting HFV. Results: This study included 112
neonates with a median birth weight of
938 (IQR: 692 - 1549) grams and gestational
age of 27.2 (24.6 - 30.7) weeks. The first pCO2 after starting HFV (mean (SD)) was 53.7 (22) mmHg. Of 112, 15 (13.4%) showed
initial hypocapnia (pCO2 35 mmHg), and 17 (15.2%) showed hypercapnia (pCO2 > 65 mmHg)—a total of 28.6% unacceptable pCO2 levels. Of 112, the first
blood gas was obtained within 30 minutes in 47 (42%) and within one hour in 85
(76%), with a significant delay of two or more hours in eight (7.1%). Conclusion: Many neonates had unacceptable pCO2 levels upon starting
first-time HFV. There were significant delays in obtaining the initial gas.