Protocolo de ventilación del alta frecuencia en pediatría.

Abstract

High-frequency oscillatory ventilation (HFOV) is a significant advance in the management of children with critical respiratory diseases, allows oxygenation and ventilation with lower peak pressures than conventional ventilation and less variations in alveolar pressure and volumes Although used primarily as a lung rescue technique in neonates, HFOV indications may be broader rather than as a final ventilation strategy in critically ill patients. Problem:In our country, there is not enough experience or pediatric medical evidence to demonstrate the advantages of using HFOV and its impact on reducing mortality in children with acute respiratory failure or acute respiratory distress syndrome (ARDS) compared to other treated with conventional ventilation. Objectives:To describe the experience the use of HFOV in the patients of the Pediatric Intensive Care Unit of the Dr. Roberto Gilbert Elizalde hospital. To analyze the response curves of the oxygenation index and PAFI before and after the use of HFOV; and to propose a general practical protocol for theuse of HFOV. Materials and Methods:Documentary study, since the data were obtained from the medical records of pediatric patients hospitalized in intensive therapy from January to June 2016. Inclusion criteria:weight less than 12 kilos, acute respiratory failure of any etiology, acute respiratory distress syndrome (ARDS) , air leakage syndromes, oxygenation index above 13, mean airway pressure above 15. Exclusion Criteria:Patients who did not meet the clinical parameters to enter HFOV. Infantswith chronic respiratory diseases, postsurgical, hemodynamically unstable patients. Conclusions:When conventional modalities were not effective, HFOV is a ventilatory support option in critically ill children. Based on available information, it was evidenced that the majority of patients who had IOP prior to HFOV greater than 20 and who did not present any improvement at 6 hours died.