Researchers at King’s College London have found that premature babies supported immediately after birth by high-frequency oscillatory ventilation (HFOV) had better lung function as adolescents compared to those who received conventional ventilation.
According to the study, children ventilated with the high frequency method also showed higher academic achievement in three of eight school subjects.
The findings of the research, funded by the National Institute for Health Research (NIHR), Health Technology Assessment Program (HTA) and others, aims to change the use of ventilation in neonatal units across the UK, where an estimated 60,000 babies are born prematurely each year.
As explained by the researchers, babies born extremely prematurely are at a high risk of developing breathing problems as their lungs are not yet mature and can be damaged by the breathing support that is needed to keep them alive.
Breathing support can be provided by conventional ventilation, which assists spontaneous breathing, or by high-frequency oscillatory ventilation. During HFOV smaller, shorter bursts of gas are delivered, which may be less damaging to the young child’s fragile lungs, and therefore may reduce the chronic respiratory problems experienced by babies born very prematurely.
The study, published in the New England Journal of Medicine, is the first at King’s to examine whether HFOV improves the lung function in children who were born very prematurely. The children supported by HFOV, who were entered into a randomized trial at birth, via a United Kingdom Oscillation Study (UKOS), were found to have superior lung function on a number of measures between the ages of 11 and 14, compared to children who had been supported by conventional ventilation at birth. A series of assessments at King’s College Hospital found, in particular, that the children were able to breathe out more easily.
Results from some early studies raised concern that HFOV might be associated with an increased risk of bleeding into the brain, which would put babies at increased risk of neurodevelopmental problems. In UKOS, there were no significant differences in the occurrence of bleeding into the brain, and the current follow-up study found no evidence of adverse neurological effects.
Some cognitive skills were found to be enhanced in the HFOV group. However, the children’s teachers completed questionnaires designed to measure academic achievement demonstrated that the children supported by HFOV after birth were rated significantly higher in three of the eight school subjects assessed: art and design, information technology, and design and technology suggesting they had better visual and spatial abilities.