Intermittent sigh breaths during high-frequency oscillatory ventilation in preterm infants : A randomised crossover study

Journal article

Hough, Judith Leigh, Jardine, Luke, Hough, Matthew James, Steele, Michael, Greisen, Gorm and Heiring, Christian. (2025). Intermittent sigh breaths during high-frequency oscillatory ventilation in preterm infants : A randomised crossover study. Archives of Disease in Childhood: Fetal and Neonatal Edition. 110(3), pp. 297-302. https://doi.org/10.1136/archdischild-2024-327445
AuthorsHough, Judith Leigh, Jardine, Luke, Hough, Matthew James, Steele, Michael, Greisen, Gorm and Heiring, Christian
Abstract

Objective
To determine if combining high-frequency oscillatory ventilation (HFOV) with additional sigh breaths would improve end-expiratory lung volume (EELV) and oxygenation in preterm infants.

Design
Prospective interventional crossover study.

Setting
Neonatal intensive care unit.

Patients
Ventilated preterm infants <36 weeks corrected gestational age receiving HFOV.

Interventions
Infants were randomly assigned to receive HFOV with sigh breaths followed by HFOV-only (or vice versa) for four alternating periods. Sigh breaths were delivered with an inspiratory time of 1 s, peak inspiratory pressure of 30 cmH20 and frequency of three breaths/min.

Main outcome measures
Electrical impedance tomography measured the effect of sigh breaths on EELV and ventilation distribution. Physiological variables were recorded to monitor oxygenation. Measurements were taken at 30 and 60 min postchange of HFOV mode and compared with baseline.

Results
Sixteen infants (10 males, 6 females) with a median (range) gestational age at birth of 25.5 weeks (23–31), study weight of 950 g (660–1920) and a postnatal age of 25 days (3–49) were included in the study. The addition of sigh breaths resulted in a significantly higher global EELV (mean difference±95% CI) (0.06±0.05; p=0.04), with increased ventilation occurring in the posterior (dependent) and left lung segments, and improved oxygen saturations (3.31±2.10; p<0.01).

Conclusion
Intermittent sigh breaths during HFOV were associated in the short-term with an increased EELV in the posterior and left lungs, and improved oxygen saturations in preterm infants.

Year2025
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Journal citation110 (3), pp. 297-302
PublisherBMJ Publishing Group
ISSN1468-2052
Digital Object Identifier (DOI)https://doi.org/10.1136/archdischild-2024-327445
PubMed ID39406472
Scopus EID2-s2.0-85207806615
Page range297-302
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online15 Oct 2024
Publication process dates
Accepted30 Sep 0202
Deposited08 May 2025
Additional information

© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

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Alcorn, Kylie, Gerrard, John, Macbeth, Deborough and Steele, Michael Craig. (2013). Seasonal variation in health care-associated bloodstream infection: Increase in the incidence of gram-negative bacteremia in nonhospitalized patients during summer. American Journal of Infection Control. 41(12), pp. 1205 - 1208. https://doi.org/10.1016/j.ajic.2013.05.019
Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: A randomised controlled trial
Perez, Siegfried R.S., Keijzers, Gerben B., Steele, Michael Craig, Byrnes, Joshua and Scuffham, Paul A.. (2013). Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: A randomised controlled trial. EMA - Emergency Medicine Australasia. 25(6), pp. 527 - 534. https://doi.org/10.1111/1742-6723.12151
A comparison of the power of the discrete Kolmogorov-Smirnov and Chi-Square goodness-of-fit tests
Steele, Michael Craig, Smart, Neil A., Hurst, Cameron and Chaseling, Janet. (2012). A comparison of the power of the discrete Kolmogorov-Smirnov and Chi-Square goodness-of-fit tests. In K. Kumar and A. Chaturvedi (Ed.). International Conference on Recent Developments in Statistics, Econometrics and Forecasting, University of Allahabad, India, December 27-28, 2010. United States of America: Brown Walker Press. pp. 104 - 109
Baseline evidence based practice use, knowledge, and attitudes of allied health professionals : A survey to inform staff training and organisational change
Wilkinson, Shelley, Hinchliffe, Fiona, Hough, Judith and Chang, Anne. (2012). Baseline evidence based practice use, knowledge, and attitudes of allied health professionals : A survey to inform staff training and organisational change. Journal of Allied Health. 41(4), pp. 177 - 184.
Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure
Hough, Judith L., Johnston, Leanne, Brauer, Sandy G., Woodgate, Paul G., Pham, Trang MT and Schibler, Andreas. (2012). Effect of body position on ventilation distribution in preterm infants on continuous positive airway pressure. Pediatric Critcal Care Medicine. 13(4), pp. 446 - 451. https://doi.org/10.1097/PCC.0b013e31822f18d9
Talipes equinovarus (clubfoot)
Hough, Judith Leigh, Bagley, Catherine and Koorts, Pieter J.. (2012). Talipes equinovarus (clubfoot). In In M. W. Davies, G. D. T. Inglis and L. A. Jardine & P. J. Koorts (Ed.). Antenatal consults : A guide for neonatologists and paediatricians pp. 281-284 Churchill Livingstone.
Reduction of post-surgical pericardial adhesions using a pig model
Alizzi, Ali M., Summers, Phillip, Boon, Virginia H., Tantiongco, John-Paul, Thompson, Teresa, Leslie, Belinda J., Williams, David, Steele, Michael Craig, Bidstrup, Benjamin P. and Diqer, Al-Mutazz A.. (2012). Reduction of post-surgical pericardial adhesions using a pig model. Heart, Lung and Circulation. 21(1), pp. 22 - 29. https://doi.org/10.1016/j.hlc.2011.10.002
Lung recruitment manoeuvres for reducing respiratory morbidity in mechanically ventilated neonates
Jauncey-Cooke, J, Bogossian, F, Hough, J., Schibler, A, Davies, M W., Grant, C A., Gibbons, K and East, C E.. (2012). Lung recruitment manoeuvres for reducing respiratory morbidity in mechanically ventilated neonates. Cochrane Database of Systematic Reviews. Art.No.: CD009969 (Issue 7). https://doi.org/10.1002/14651858.CD009969
Humidified high flow nasal cannulae : Current practice in Australasian nurseries, a survey
Hough, Judith, Shearman, Andrew, Jardine, Luke and Davies, Mark. (2012). Humidified high flow nasal cannulae : Current practice in Australasian nurseries, a survey. Journal of Paediatrics and Child Health. 48(2), pp. 106 - 113. https://doi.org/10.1111/j.1440-1754.2011.02070.x
A comparison of 16 weeks of continuous vs intermittent exercise training in chronic heart failure patients
Smart, Neil A. and Steele, Michael Craig. (2012). A comparison of 16 weeks of continuous vs intermittent exercise training in chronic heart failure patients. Congestive Heart Failure. 18(4), pp. 205 - 211. https://doi.org/10.1111/j.1751-7133.2011.00274.x
Prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B streptococcus urinary tract infection: A 4-year retrospective study in adult patients
Tan, Chee K., Ulett, Kimberly B., Steele, Michael C., Benjamin, William H. and Ulett, Glen C.. (2012). Prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B streptococcus urinary tract infection: A 4-year retrospective study in adult patients. BMC Infectious Diseases. 12(273), pp. 1 - 8. https://doi.org/10.1186/1471-2334-12-273
Using community surveillance data to differentiate between emerging and endemic amphibian diseases
Young, Sam, Skerratt, Lee F., Mendez, Diana, Speare, Rick, Berger, Lee and Steele, Michael Craig. (2012). Using community surveillance data to differentiate between emerging and endemic amphibian diseases. Diseases of Aquatic Organisms. 98(1), pp. 1 - 10. https://doi.org/10.3354/dao02416
The effect of physical training on systemic proinflammatory cytokine expression in heart failure patients: A systematic review
Smart, Neil A. and Steele, Michael Craig. (2011). The effect of physical training on systemic proinflammatory cytokine expression in heart failure patients: A systematic review. Congestive Heart Failure. 17(3), pp. 110 - 114. https://doi.org/10.1111/j.1751-7133.2011.00217.x
The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics :A randomised controlled study
Szlezak, Adam, Georgilopoulos, Peter, Bullock-Saxton, Joanne and Steele, Michael. (2011). The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics :A randomised controlled study. Manual Therapy. 16, pp. 609 - 613. https://doi.org/10.1016/j.math.2011.06.004
Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery
Schibler, Andreas, Pham, Trang, Dunster, Kimble, Foster, Kim, Barlow, A, Gibbons, Kristen and Hough, Judith. (2011). Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery. Intensive Care Medicine. 37(5), pp. 847 - 852. https://doi.org/10.1007/s00134-011-2177-5
The impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes
Crilly, Julia, Keijzers, Gerben B., Krahn, Dirken, Steele, Michael Craig, Green, David and Freeman, Janeen. (2011). The impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes. Quality Management in Health Care. 20(4), pp. 322 - 333. https://doi.org/10.1097/QMH.0b013e318231355a
Exercise training in haemodialysis patients: A systematic review and meta-analysis
Smart, Neil and Steele, Michael Craig. (2011). Exercise training in haemodialysis patients: A systematic review and meta-analysis. Nephrology. 16(7), pp. 626 - 632. https://doi.org/10.1111/j.1440-1797.2011.01471.x
Measurement of ventilation and cardiac related impedance changes with electrical impedance tomography
Grant, Caroline, Pham, Trang, Hough, Judith, Riedel, T, Stocker, C and Schibler, Andreas. (2011). Measurement of ventilation and cardiac related impedance changes with electrical impedance tomography. Critical Care. 15(1), pp. 1 - 9. https://doi.org/10.1186/cc9985
Tertiary survey performance in a regional trauma hospital without a dedicated trauma service
Keijzers, Gerben B., Campbell, Don, Hooper, Jeffrey, Bost, Nerolie, Crilly, Julia, Steele, Michael Craig, Eddington, Blake and Geeraedts, Leo M.G.. (2011). Tertiary survey performance in a regional trauma hospital without a dedicated trauma service. World Journal of Surgery. 35(10), pp. 2341 - 2347. https://doi.org/10.1007/s00268-011-1231-3
Evaluating the statistical power of goodness-of-fit tests for health and medicine survey data
Steele, M., Smart, N., Hurst, C. and Chaseling, J.. (2009). Evaluating the statistical power of goodness-of-fit tests for health and medicine survey data. In R.S. Anderssen, R.D. Braddock and L.T.H. Newham (Ed.). The 18th World IMACS Congress and MODSIM09 International Congress on Modelling and Simulation. United States of America: Modelling and Simulation Society of Australia and New Zealand and International Association for Mathematics and Computers in Simulation, July 2009. pp. 192 - 196
Identifying significant contributors to milk production in the absence of the herd size effect
Zamykal, Daniel, Steele, Mike, Kerr, Don and Chaseling, Janet. (2007). Identifying significant contributors to milk production in the absence of the herd size effect. In Oxley, L. and Kulasiri, D. (Ed.). MODSIM 2007 International Congress on Modelling and Simulation. University of Canterbury, Christchurch, New Zealand 10 - 13 Dec 2007 Christchurch, New Zealand: Modelling and Simulation Society of Australia and New Zealand Inc.. pp. 88-93