The usage of superimposed high-frequency jet ventilation in the treatment of acute respiratory distress syndrome in children with oncohematological diseases

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Abstract

The treatment of acute respiratory distress syndrome (ARDS) in children with oncohematological diseases remains one of the most difficult problem of the intensive care. The present study was performed to assess  the potential of the usage of superimposed highfrequency jet ventilation (SHFJV) in the treatment of ARDS  in children with oncohematological diseases. High-frequency ventilation was performed with TwinStream™  (Carl Reiner, Austria) apparatus in the superimposed high-frequency jet ventilation mode. 13 cases of ARDS treatment were analysed. High-frequency ventilation was indicated in cases of a confirmed ARDS or the  inefficacy of conventional mechanical ventilation: peak airway pressure (Ppeak) > 30 mm Hg, FiO2 – 100%, SpO2 < 92%, pCO2 > 50 mm Hg. SHFJV was conducted for 2–12 days (5±3 days on average). 10 patients  (76,9%) showed an improvement in lung X-ray, increased levels of РаО2 > 100 mm Hg, РаО2/FiO2 > 200,  a reduced fraction of inspired oxygen (FiO2), the optimization of SHFJV parameters with a subsequent  switch-over to traditional ALV techniques and extubation. Five out of 13 patients died. The first results of  SHFJV application in oncohematological pediatric patients with severe ARDS showed the efficacy of this  alternative method used when adequate gas exchange cannot be achieved with traditional methods of lung ventilation.

About the authors

A. Yu. Ivanashkin

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

Author for correspondence.
Email: ivanashkin@mail.ru
ORCID iD: 0000-0002-4348-4573

MD, Intensive Care Unit

Russia 117997, Moscow, Samory Mashela st., 1 Tel.: 8(495) 664-7745

Russian Federation

I. G. Khamin

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

ORCID iD: 0000-0001-8264-2258
Russian Federation

A. S. Rybalko

National Scientific and Practical Center of Children’s Health

ORCID iD: 0000-0001-9650-7292
Russian Federation

I. A. Semyonov

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

ORCID iD: 0000-0002-4695-9765
Russian Federation

U. N. Petrova

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation

ORCID iD: 0000-0002-1258-8281
Russian Federation

V. V. Lazarev

Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-8417-3555
Russian Federation

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Copyright (c) 2017 Ivanashkin A.Y., Khamin I.G., Rybalko A.S., Semyonov I.A., Petrova U.N., Lazarev V.V.

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