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KMID : 0191120000150020153
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Journal of Korean Medical Science
2000 Volume.15 No. 2 p.153 ~ p.158
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Comparison of respiratory indices in predicting response to high frequency oscillatory ventilation in very low birth weight infants with respiratory distress syndrome
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Ko SY
Chang YS/Park WS
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Abstract
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To evaluate the predictive values of oxygenation index (OI), arterial-alveolar oxygen tension
ratio (a/APO)2, and alveolar-arterial oxygen gradient ((A-a)DO2) for early recognition of
responsiveness to high frequency oscillatory ventilation (HFOV) in very low birth weight
infants with respiratory distress syndrome (RDS), 23 infants who received HFOV treatment
for severe RDS after failing to be improved with conventional mechanical ventilation from
July 1995 to February 1998 were included. Twelve infants survived with HFOV (Responder
group), while 11 infants could not maintain oxygenation with HFOV and died (Non-responder
group). Clinical record (of each patient) were retrospectively reviewed and compared with
the respiratory indices. Mean (A-a)DO2 was significantly lower in the responder group than
in the non-responder group at 2 hr after HFOV (p=0.024), and the difference was more
remarkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2 hr after
HFOV therapy was 100% in sensitivity and 80% in specificity. The earliest significant
difference of mean a/APO2 between two groups was noted at 6 hr after HFOV treatment
(p=0.019). OI showed no significant differences between two groups. In summary, (A-a)DO2
was the most effective and sensitive respiratory index for predicting the responsiveness
to HFOV in infants with severe RDS providing due as early as 2 hr.
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