Effects of high-frequency volume-guaranteed ventilation in preterm newborns with respiratory distress syndrome: exploratory review

Abstract

High-frequency oscillatory ventilation with volume guarantee (HFOV-VG) is a ventilatory mode that controls small tidal volumes at supraphysiological frequencies, potentially beneficial for preterm infants with respiratory distress syndrome (RDS).

Objective: To identify the physiological and clinical effects of HFOV-VG in preterm newborns with RDS, compared with conventional HFOV.

Method: Exploratory review of studies published between 2019 and 2023 of preterm newborns from 23 to 36 weeks of gestation with RDS, weighing ≥ 450g, with invasive HFOV support, using PRISMA flow diagram. For their critical evaluation, the MINORS and PEDro scales were used.

Results: 1,386 articles were initially identified, of which 7 articles were selected. Compared with conventional HFOV, the use of lower tidal volumes (VThf) and higher respiratory rate stands out, as well as better and more stable gas exchange, both as an elective or early rescue strategy in preterm newborns with RDS. Furthermore, an inverse relationship is observed between VThf and respiratory rate.

Conclusion: HFOV-VG, used in preterm neonates with RDS, consistently improves oxygenation and ventilation compared with conventional HFOV. Control and reduction of VThf could provide additional lung protection.