HFOV With Intermittent Sigh Breaths in Neonate: CO2 Level

The goal of this clinical trial is to the short-term effects of sigh breaths during High-frequency oscillatory ventilation (HFOV) in neonate undergoing mechanical ventilation. From meta-analysis, It revealed HFOV in neonates could reduce chronic lung disease or death rather than conventional ventilation.The main question it aims to answer is: Do sigh breaths augment restoring lung volume and ventilation (CO2 level) in intubated neonate with HFOV? Participants will be applied sigh breaths (HFOV-sigh) during on HFOV. Researchers will compare HFOV-sigh mode to see if CO2 level (before-after intervention).

Inclusion Criteria:Preterm and term neonate (gestational age 24-41 weeks) with postnatal age less than 28 daysAlready ventilated with high frequency ventilation at least 1 hoursAn umbilical or peripheral arterial catheterization was availableExclusion Criteria:Previous or current pulmonary air leaks (pulmonary interstitial emphysema, pneumothorax, pneumomediastinum, and pneumopericardium)Heterogeneous lung disease including MAS, congenital diaphragmatic herniaSuspected lung hypoplasiaSuspected or confirmed intraventricular hemorrhage grade III-IVSuspected or confirmed hypoxic ischemic encephalopathy or 5-min Apgar score less than 3Hemodynamic instability despite using inotrope(s)Arterial pCO2 level less than 45 mm Hg or more than 70 mm Hg before interventionNeed a new arterial puncture for samples both before and after interventionsMoribund statusParents' decision not to participate