Why High-Frequency Ventilators Are Used in the NICU

Newborn wearing a ventilator, holding an adult's finger

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A high-frequency ventilator (HFV) is a ventilator that delivers breaths much faster than a conventional ventilator. HFVs are a type of mechanical ventilation for premature newborns. Very sick preemies may need faster ventilator support to learn how to breathe on their own. Conventional ventilators may deliver about 20 to 60 breaths per minute, but high-frequency ventilators can deliver close to 1,000 breaths per minute.

The Use of High-Frequency Ventilators for Fragile Lungs

High-frequency ventilators are often used in the NICU for very small or very sick premature babies. These preemies have lungs that are easily damaged by the respiratory support that is necessary to keep them alive. This damage is called chronic lung disease. High-frequency ventilators are thought to be gentler for a preemie's tiny airways, with the goal of preventing lung damage in babies who will need to be ventilated for long periods of time.

3 Types of High-Frequency Ventilators

There are three different types of high-frequency ventilators that are used for varying purposes.

  • Oscillating ventilators, or oscillators (HFOV, rate 300-3000/minute)
  • Jet ventilators (HFJV, rate 100-600)
  • High-frequency flow interrupters or positive pressure ventilation (HPPV, rate 60-150/minute)

As your preemie's stay in the hospital progresses, you may see one of these used for your child.

Complications 

There may be complications from use of high-frequency ventilators in children. Atelectasis, a complete or partial collapse of a lung or lobe of a lung, is one such complication. Hypotension or abnormally low blood pressure is another complication of high-frequency ventilators. Doctors and nurses will look to change the settings of your preemie's HFV if these complications occur.

Weaning

As they show improvement, babies will slowly be weaned off of high-frequency ventilators and learn to breathe on their own.

The time it takes to wean a baby from an HFV will vary greatly depending on their ability to breathe on their own, their lung volume, and whether or how long they can maintain lung volume as they learn to breathe.

Over time, as the baby is able to sustain a healthy breathing pattern, the time they are on an HFV will decrease as time breathing on their own is increased.

A Word From Verywell

While it is hard to watch your child require a machine to breathe for them, many premature newborns need this advanced technology to live. Doctors and nurses in the NICU will balance the need for treatment with the risks that using a ventilator can bring.

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  1. Huang CT, Lin HH, Ruan SY, Lee MS, Tsai YJ, Yu CJ. Efficacy and adverse events of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome: a meta-analysisCrit Care. 2014;18(3):R102. doi:10.1186/cc13880