ABSTRACT 394: HIGH-FREQUENCY OSCILLATORY VENTILATION IN TERM AND NEAR TERM INFANTS WITH MECONIUM ASPIRATION SYNDROME

Background and aims: High frequency oscillatory ventilation (HFOV) is now frequently used as rescue treatment of hypoxemic neonates with meconium aspiration syndrome (MAS). Aims: The aim of the study was to describe the experience with HFOV in a Pediatric Critical Care Unit, and to evaluate whether HFOV allowed improvement in oxygenation and ventilation in term and near term (>34 GA) with (MAS). Methods: This was a retrospective observational cohort study of infants ventilated by HFOV between January, 2007 and October, 2013. All infants were born out. The following parameters were recorded: demographic and clinical data, blood gases and ventilatory parameters during the first 48 hours of HFOV. Results: Twenty one children were included (median age =12 hours (IQR 2–48 h)). In Almost all infants (95%) had gestational age >37weeks. Conventional mechanical ventilation was used in 17 patients (80%) prior to HFOV (median duration = 7 hours (IQR 1–72 h)). All patients who started HFOV had hypoxemia, and 6 (28 %) also presented hypercapnia (>45 mm hg). twelve hours after starting HFOV, a significant improvement in PaO2/FiO2 ratio (123+/-40 vs. 239 ± 69; p=0.005) and in PH (7,14+/-0,05vs 7,35+/-0,08; p=0,035) were observed. Twenty patients (95%) required inotropic support and 19 (90%) required inhaled nitric oxide. Pneumothorax on HFVO was observed in7 Cases (33%). The survival rate was 85%. Conclusions: HFOV enabled an improvement in hypercapnia and oxygenation. It is a safe option for the treatment of MAS in early rescue intervention or in a second line.