Lung Recruitment Using High-Frequency Oscillation Volume Guarantee in Preterm Infants with Evolving Bronchopulmonary Dysplasia

Background: Stepwise lung recruitment maneuvers (LRMs) may be used in ventilated preterm infants. However, its use in high-frequency oscillation with volume guarantee (HFO-VG) is not well studied. Methods: Preterm infants treated with HFO-VG who had LRMs were identified. Patient and respiratory parameters were recorded. Results: Ten infants, median GA 25+6 (IQR 24+2–27+0) weeks, and 21 LRMs were identified. LRMs were performed at a median age of 26 days, with a starting MAP of 16 (14–17) cm H2O and the highest MAP of 23.5 (22.0–24.8) cm H2O. Most (76%) resulted in immediate improved SpO2/FiO2. There were no sustained differences in median oxygen saturation index (8.4 vs. 9, p = 0.09), SpO2/FiO2 (1.8 vs. 1.8, p = 0.8), ∆P (21 vs. 23, p = 0.64), or transcutaneous CO2 (58 vs. 60, p = 0.84) in 24 h before and after LRMs. Conclusions: In preterm infants with evolving bronchopulmonary dysplasia, LRMs on HFO-VG did not result in sustained improvement to oxygenation or ventilation.