Using the High Frequency Ventilation during Neonatal Transport

ABSTRACT

PURPOSE: To present and evaluate a system of high-frequency oscillatory ventilator (HFOV) during intra-/inter-hospital neonate transport. METHODS: The system includes a charged HFOV (SOPHIE, Fritz Stephan GmbH, Dusseldorf, Germany), an incubator, and E-oxygen/air-cylinders with connections to the HFOV. The test lung was evaluated at the high and medium ventilator settings used for infants to determine the operating time of HFOV. The time required to exhaust the gas supply was checked, and the HFOV was operated until the low-battery alarm sounded to determine the operating time of the batteries. RESULTS: The batteries provided electrical power for at least 60 mins, and the oxygen and air-cylinders lasted at least 20 mins. The system has been used frequently for the intra-hospital transport, from delivery rooms to ICU and from ICU for surgery. The system has been used twice for the inter-hospital transport of infants with bronchopulmonary dysplasia and pulmonary hypertension to another hospital 45 km away (one hour distance). In one case, the ambulance's electrical power supply failed, causing the system failure during the last 5 mins of transport. However, with the complete check and simulation of the system and the ambulance bulk oxygen/electric supply, the second patient was transported successfully in stable condition. CONCLUSION: The system was useful for intra-/inter-hospital transport of the neonates on HFOV. For the transport time of 60 mins, fully charged HFOV, 2 E-oxygen-cylinders, and 3 E-air-cylinders seemed to be sufficient. H-oxygen-cylinder and ambulance electrical power supply should also be provided for safe and efficient transport between hospitals.