Electrical cardiometry changes in full-term neonates with persistent pulmonary hypertension on high-frequency mechanical ventilation versus conventional mechanical ventilation

Abstract Background Persistent pulmonary hypertension of the newborn (PPHN) is characterized by high pulmonary vascular resistance, causing right-to-left blood shunting and respiratory distress. High-frequency oscillatory ventilation (HFOV) is used to improve oxygenation in PPHN cases. This study aimed to evaluate the hemodynamic changes in neonates with PPH on HFOV compared to conventional mechanical ventilation (CMV) using electrical cardiometry (EC). Methods This prospective cohort study included 58 full-term neonates with PPHN, admitted to a neonatal intensive care unit (NICU). Neonates were divided into two groups; group 1: those receiving CMV, and group 2: those switched to HFOV after CMV failure. Measurement of EC were taken at day 0, 1, 3, and 7 of MV. Results Cardiac output, index of contractility, and stroke volume were significantly lower in the HFOV group compared to the CMV at days 0, 1, 3, and 7. However, they significantly improved in both groups, but the improvement was less significant in the HFOV group. Systemic vascular resistance and thoracic fluid content were comparable between both groups at days 0, 1, 3, and 7. Conclusions Both HFOV and CMV improve the hemodynamic status in full-term neonates with PPHN. However, hemodynamic improvement was more obvious in the CMV group than in the HFOV group. Hence, HFOV should be used in PPHN only in severe cases.