Superimposed high-frequency jet ventilation in children with oncohematological diseases and acute respiratory distress syndrome

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Abstract

BACKGROUND: The mortality rate of children with hematological cancer and acute respiratory distress syndrome is still high, which is often associated with the ineffectiveness of traditional mechanical ventilation methods in the treatment of critical hypoxemia in these patients. Currently, the search continues for alternative methods of respiratory support, one of which is the combined high-frequency jet artificial ventilation of the lungs.

AIM: This study aimed to evaluate the efficacy and safety of combined high-frequency jet artificial ventilation in the treatment of children with hematological malignancies and severe acute respiratory distress syndrome.

MATERIALS AND METHODS: The study was conducted in the Department of Resuscitation and Intensive Care of the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, from 2016 to 2020. Combined high-frequency jet artificial ventilation was used as an alternative method of respiratory support.

RESULTS: In case of severe hypoxemia caused by secondary severe acute respiratory distress syndrome, the use of combined high-frequency jet ventilation after 12 h leads to a significant improvement in arterial blood oxygenation, improves the biomechanical characteristics of the respiratory system, and reduces the likelihood of developing ventilator-associated lung damage. An increase in oxygenation and absence of an effect on the indicators of central hemodynamics provide a greater delivery of oxygen to the tissues, thereby improving the general condition of the patients.

CONCLUSIONS: In severe parenchymal respiratory failure accompanied by critical hypoxemia, combined high-frequency jet artificial ventilation of the lungs can be considered an alternative method of respiratory support.

About the authors

Aleksey Yu. Ivanashkin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Author for correspondence.
Email: ivanashkin@yandex.ru
ORCID iD: 0000-0002-4348-4573
SPIN-code: 2694-6501

anesthesiologist-resuscitator

Russian Federation, 1, Samory Mashela st., 117997, Moscow

Galina A. Novichkova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: gnovichkova@yandex.ru
ORCID iD: 0000-0002-2322-5734
SPIN-code: 7890-1419

Dr. Sci. (Med.), Professor, General Director

Russian Federation, 1, Samory Mashela st., 117997, Moscow

Vladimir V. Lazarev

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; Pirogov Russian National Research Medical University

Email: lazarev_vv@inbox.ru
ORCID iD: 0000-0001-8417-3555
SPIN-code: 4414-0677

Dr. Sci. (Med.), Professor, Head of the Department of Pediatric Anesthesiology and Intensive Care, anesthesiologist-resuscitator

Russian Federation, 1, Samory Mashela st., 117997, Moscow; Moscow

Igor G. Khamin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: igorhamin@yandex.ru
ORCID iD: 0000-0001-8264-2258
SPIN-code: 8369-1378

Cand. Sci. (Med.), Head of the Department of Pediatric Anesthesiology and Intensive Care, anesthesiologist-resuscitator

Russian Federation, 1, Samory Mashela st., 117997, Moscow

Leonid E. Tsypin

Pirogov Russian National Research Medical University

Email: cypin1939@mail.ru
ORCID iD: 0000-0002-3114-8759
SPIN-code: 5062-2010

Dr. Sci. (Med.), Professor of Children Anesthesiology and Intensive Care Department

Russian Federation, 1, Samory Mashela st., 117997, Moscow

Elena A. Spiridonova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: spiridonova.e.a@gmail.com
ORCID iD: 0000-0002-5230-5725
SPIN-code: 1729-8002

Dr. Sci. (Med.), Professor

Russian Federation, 1, Samory Mashela st., 117997, Moscow

Aleksey A. Maschan

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: hemoncim@yandex.ru
ORCID iD: 0000-0002-0016-6698
SPIN-code: 4505-2346
Scopus Author ID: 55915056400
ResearcherId: A-4792-2019

Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences

 

 

 

Russian Federation, 1, Samory Mashela st., 117997, Moscow

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Supplementary files

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1. JATS XML
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2. Fig. 1. Dynamics of “driving pressure” and static compliance. Lung recruitment test (p < 0.0000; Wilcoxon Rank-Sum Test)

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3. Fig. 2. Dynamics of saturation at the research stages. *p < 0.000022; Wilcoxon Rank-Sum Test

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4. Fig. 3. Dynamics of oxygen partial pressure at the research stages. *p < 0.00048; **p < 0.00365; Wilcoxon Rank-Sum Test

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5. Fig. 4. Dynamics of the respiratory index at the research stages. *p < 0.00048; **p < 0.00365; Wilcoxon Rank-Sum Test

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6. Fig. 5. Dynamics of the oxygenation index at the stages of the study. *p < 0.00048; **p < 0.05; ***p < 0.0033895; Wilcoxon Rank-Sum Test

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7. Fig. 6. Dynamics of the “plateau pressure” at the research stages. *p < 0.015293; Wilcoxon Rank-Sum Test

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8. Fig. 7. Dynamics of “driving pressure” at the research stages. *p < 0.0000086; Wilcoxon Rank-Sum Test

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9. Fig. 8. Dynamics of biomechanical properties of the respiratory system at the research stages. *p < 0,0088; Wilcoxon Rank-Sum Test

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10. Fig. 9. Dynamics of cardiac output at the stages of the study. ANOVA Chi Sqr. = 6.317308, p = 0.38860; Friedman test

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11. Fig. 10. Dynamics of the severity of the patients’ condition at the stages of the study. *р ≤ 0.0033; Wilcoxon Rank-Sum Test. ANOVA Chi Sqr. = 4.713740, p = 0.45181; Friedman test

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12. Fig. 11. Dynamics of the oxygen delivery index. *р ≤ 0.0029; Wilcoxon Rank-Sum Test; ANOVA Chi Sqr. = 9.052863, p = 0.10698; Friedman test

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