Effectiveness of high-frequency ventilation during acute respiratory distress syndrome in children of one year of age after cardiac surgery

Abstract

The main objectives of ventilation for ARDS are to eliminate hypercapnia, improve oxygenation and prevent ventilator-induced lung damage.

The aim of the work was to evaluate the effectiveness of using high-frequency ventilation in ARDS in 15 children operated on congenital heart defects in conditions of artificial circulation.

Materials and methods. From August 2014 to March 2018 in the “National M. M. Amosov Institute of Cardiovascular Surgery National Academy of Medical Sciences of Ukraine” 15 children in the age of from 5 days to 6 months (weight from 3 kg to 6 kg) with an ventricular septal defect with pulmonary hypertension (LH), atrioventricular communication with LH, transposition of the great arteries underwent heart bypass surgery.

Results. All children had an improvement in the gas composition of blood in 3 hours after the beginning of the high frequency ventilation. On traditional mechanical ventilation with “hard” parameters before the beginning of high frequency ventilation, such indices of the arterial blood gas composition were noted: pH 7.1; pCO2 80 mmHg; BE-15; PaO2 50 mmHg; SaO2 60%, and after 3 hours on the RF: pH 7.4; pCO2 35 mmHg; BE-3; PaO2 70 mmHg; SaO2 90%.

Conclusions. The early stages of ARDS ventilation by the HFV method in children of the first year of life with CHD were accompanied by an improvement in the gas exchange of the arterial blood, as indicated by a reduction in the oxygenation index and signs of ventilator-induced lung damage.