High frequency percussive ventilation in pediatric patients with inhalation injury

Joaquin Cortiella, Ron Mlcak, David Herndon

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

The objective of this study was to present data that showed high frequency percussive ventilation (HFPV) was superior to traditional mechanical ventilation for the treatment of children with inhalation injuries. Inhalation injuries continue to be the number one cause of death of patients with thermal injuries in the United States. Therapy for this condition has consisted of conservative pulmonary toilet and mechanical ventilation. Despite improvements in the management of burn injury, patients with inhalation injury develop pneumonia and pneumothorax, leading to adult respiratory distress syndrome. Unfortunately, inhalation injury that is complicated by pneumonia has been shown to increase mortality by 60% in these patients. Cioffi has shown that prophylactic use of HFPV in adult patients with inhalation injury has been a successful method of reducing the incidence of pneumonia and mortality. The effects of HFPV on the incidence of pneumonia, peak inspiratory pressures, and arterial partial pressure of oxygen/fraction of inspired concentration of oxygen (P/F) ratios were retrospectively studied in 13 children with inhalation injuries and compared with historic controls treated with conventional mechanical ventilation. All patients were treated with our standard inhalation injury protocol and extubated when they met standard extubation criteria. Patients ranged in age from 6 to 9 years, and most had burns covering greater than 50% of their total body surface areas. No deaths occurred in either group, but the patients who were treated with HFPV had no cases of pneumonia (P < .05), better P/F ratios (P < .05), lower peak inspiratory pressures, and less work of breathing (P < .05) as compared with our control group. On the basis of our clinical experience and data, the use of HFPV seems to be an effective treatment for the reduction of pulmonary morbidity in pediatric patients with inhalation injuries.

Original languageEnglish (US)
Pages (from-to)232-235
Number of pages4
JournalJournal of Burn Care and Rehabilitation
Volume20
Issue number3
StatePublished - May 1999

Fingerprint

High-Frequency Ventilation
Inhalation
Pediatrics
Wounds and Injuries
Pneumonia
Artificial Respiration
Work of Breathing
Oxygen
Pulmonary Ventilation
Mortality
Partial Pressure
Body Surface Area
Incidence
Adult Respiratory Distress Syndrome
Pneumothorax
Burns
Cause of Death
Arterial Pressure
Therapeutics
Hot Temperature

ASJC Scopus subject areas

  • Rehabilitation
  • Surgery
  • Nursing(all)
  • Health Professions(all)
  • Emergency Medicine

Cite this

High frequency percussive ventilation in pediatric patients with inhalation injury. / Cortiella, Joaquin; Mlcak, Ron; Herndon, David.

In: Journal of Burn Care and Rehabilitation, Vol. 20, No. 3, 05.1999, p. 232-235.

Research output: Contribution to journalArticle

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