Use of noninvasive high-frequency ventilation in the neonatal intensive care unit: a retrospective review.

OBJECTIVE The aim of the article is to review the effectiveness of neonatal noninvasive high-frequency ventilation (NIHFV) in preventing endotracheal mechanical ventilation. STUDY DESIGN Retrospective case series including all 79 instances of NIHFV use at four participating centers between July 2010 and September 2012. RESULTS In 73% of cases, NIHFV was used as rescue after another noninvasive mode, and prophylactically (postextubation) in the remainder. In 58% of cases, infants transitioned to another noninvasive mode, without requiring intubation. There were significant reductions in the mean (SD) number of apneas, bradycardias, or desaturations (over 6 hours) (3.2 [0.4] vs. 1.2 [0.3]; p < 0.001), FiO2 (48 [3] vs. 40 [2]%; p < 0.001) and CO2 levels (74 [6] vs. 62 [4] mm Hg; p = 0.025] with NIHFV. No NIHFV-related complications were noted. CONCLUSIONS NIHFV is a promising NIV mode that may help prevent or delay intubation and deserves further clinical research.