High-Frequency oscillatory ventilation for children with severe acute respiratory distress syndrome after cardiac surgery

Objective To compare survival of patients with acute respiratory distress syndrome after corrective cardiac surgery treated by high-frequency oscillatory ventilation with pulmonary hypertension or without pulmonary hypertension.Methods Among 10827 patients,64 with refractory acute respiratory distress syndrome were ventilated with high-frequency oscillatory ventilation.Patients with significant uncorrected residual lesions were not included.The patients were grouped according to cardiac diagnosis:group Ⅰ (n =33),non-pulmonary hypertension patients; group Ⅱ (n =31),pulmonary hypertension patients.The demographic data,respiratory and circulatory parameters were recorded.The two groups were evaluated for survival rates at discharge as the primary outcome.Results There were no significant differences between the groups with respect to age,weight,central venous pressure,left atrial pressure.The mean duration of high-frequency oscillatory ventilation was significantly shorter in group Ⅰ than that in group Ⅱ [(104.89 ± 53.47)h vs (386.49 ± 125.36)h,P＜0.05].The patients in group Ⅱ showed higher mortality rate than that in group Ⅰ [7 vs.20 (21.2％ vs.64.5％)(P＜0.05)].Conclusions High-frequency oscillatory ventilation therapy for severe postoperative acute respiratory distress syndrome is effective following cardiac surgery. Key words: Heart defects, congenital;  Acute respiratory distress syndrome;  High-frequency oscillatory ventilation;  Cardiac Surgical Procedures;