Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2017; 16: 28-34
Использование сочетанной высокочастотной струйной ИВЛ в лечении острого респираторного дистресс-синдрома у детей с онкогематологическими заболеваниями
https://doi.org/10.24287/1726-1708-2017-16-3-28-34Аннотация
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Pediatric Hematology/Oncology and Immunopathology. 2017; 16: 28-34
The usage of superimposed high-frequency jet ventilation in the treatment of acute respiratory distress syndrome in children with oncohematological diseases
https://doi.org/10.24287/1726-1708-2017-16-3-28-34Abstract
The treatment of acute respiratory distress syndrome (ARDS) in children with oncohematological diseases remains one of the most difficult problem of the intensive care. The present study was performed to assess the potential of the usage of superimposed highfrequency jet ventilation (SHFJV) in the treatment of ARDS in children with oncohematological diseases. High-frequency ventilation was performed with TwinStream™ (Carl Reiner, Austria) apparatus in the superimposed high-frequency jet ventilation mode. 13 cases of ARDS treatment were analysed. High-frequency ventilation was indicated in cases of a confirmed ARDS or the inefficacy of conventional mechanical ventilation: peak airway pressure (Ppeak) > 30 mm Hg, FiO2 – 100%, SpO2 < 92%, pCO2 > 50 mm Hg. SHFJV was conducted for 2–12 days (5±3 days on average). 10 patients (76,9%) showed an improvement in lung X-ray, increased levels of РаО2 > 100 mm Hg, РаО2/FiO2 > 200, a reduced fraction of inspired oxygen (FiO2), the optimization of SHFJV parameters with a subsequent switch-over to traditional ALV techniques and extubation. Five out of 13 patients died. The first results of SHFJV application in oncohematological pediatric patients with severe ARDS showed the efficacy of this alternative method used when adequate gas exchange cannot be achieved with traditional methods of lung ventilation.
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