High-Frequency Ventilation as a Mode of Noninvasive Respiratory Support

Abstract

High-frequency ventilation (HFV) as a mode of noninvasive respiratory support (NRS) in preterm neonates is gaining popularity. Benefits may accrue from combining the ventilatory efficiency of HFV delivered through a noninvasive interface, enhancing respiratory support while potentially limiting lung injury. Current evidence suggests that noninvasive HFV (NIHFV) may be superior to other NRS modes in eliminating carbon dioxide and preventing endotracheal ventilation after failure of other NRS modes. Animal data suggest NIHFV may promote improved alveolar development compared to endotracheal ventilation. However, adequately powered large-scale controlled trials are required to evaluate efficacy and safety prior to widespread use of NIHFV.

Keywords: Alveolar development; Bronchopulmonary dysplasia; Nasal intermittent positive pressure ventilation; Noninvasive high-frequency ventilation; Postextubation prophylaxis; Ventilation efficacy; Ventilator-induced lung injury.