{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:13:57Z","timestamp":1792109637512,"version":"4.4.0"},"reference-count":20,"publisher":"Korean Pediatric Society","issue":"2","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","award":["REC 65-407-1-1"],"award-info":[{"award-number":["REC 65-407-1-1"]}],"id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2025,2,15]]},"abstract":"<jats:p>Background: High-frequency oscillatory ventilation (HFOV) minimizes ventilator-induced lung injuries. Spontaneous sigh breathing may augment the functional residual capacity, increase lung compliance, and recruit atelectatic alveoli.Purpose: To evaluate the difference in the partial pressure of carbon dioxide (PaCO2) in neonates receiving invasive HFOV as the primary mode of respiratory support before versus after sigh breaths (Sighs).Methods: This prospective study was conducted between January and December 2023. Intubated preterm and term neonates who underwent HFOV with an available arterial line were enrolled in this study after informed parental consent was obtained. Sighs were set at a frequency of 3 breaths\/min and pressure of 5 cmH2O above the mean airway pressure for 2 hours. Arterial blood gas was collected before and after Sighs and analyzed using 2 dependent tests.Results: Thirty neonates with a mean gestational age of 33.6\u00b14.1 weeks and median date of intervention of 1.88 days (interquartile range, 0.87\u20133.79 days) were enrolled. The mean PaCO2 level was significantly lower in the HFOV with Sighs group (45.2\u00b16.6 mmHg) versus the HFOV alone group (48.8\u00b13.1 mmHg) with a mean difference (MD) of -3.6 mmHg (95% confidence interval [CI], -6.3 to -0.9; P=0.01). Subgroup analyses indicated the ability of Sighs to reduce the PaCO2 level in neonates with respiratory distress syndrome (n=15; MD [95% CI]=-4.2 [-8.2 to -0.2] mmHg; P= 0.04).Conclusion: Sighing can reduce PaCO2 levels in neonates ventilated with HFOV, particularly those with respiratory distress syndrome.<\/jats:p>","DOI":"10.3345\/cep.2024.01011","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T11:07:59Z","timestamp":1731496079000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates"],"prefix":"10.3345","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5537-4104","authenticated-orcid":true,"given":"Kulthida","family":"Baingam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2363-6362","authenticated-orcid":true,"given":"Anucha","family":"Thatrimontrichai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-7383","authenticated-orcid":true,"given":"Manapat","family":"Praditaukrit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6332-3216","authenticated-orcid":true,"given":"Gunlawadee","family":"Maneenil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5012-0463","authenticated-orcid":true,"given":"Supaporn","family":"Dissaneevate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01639-8"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd000104.pub4"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950170106"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1159\/000201738"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.12613"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198703000-00008"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.2.9032208"},{"key":"ref8","first-page":"235","volume-title":"Morphologic evidence that large inflations of the lung stimulate secretion of surfactant","author":"Massaro","year":"1983"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1980.sp013062"},{"key":"ref10","first-page":"1426","volume-title":"Sigh in patients with acute hypoxemic respiratory failure and ARDS: the PROTECTION pilot randomized clinical trial","author":"Mauri","year":"2021"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000001083"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200204000-00004"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.21739"},{"key":"ref14","first-page":"920","volume-title":"Sigh improves gas exchange and respiratory mechanics in children undergoing pressure support after major surgery","author":"Nacoti","year":"2012"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-022-04413-8"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.semperi.2021.151540"},{"key":"ref17","volume-title":"High frequency oscillatory ventilation combined with intermittent sigh breaths: Effects on blood oxygenation and stability of oxygenation [Internet]","author":"Heiring","year":"2020"},{"key":"ref18","volume-title":"High frequency oscillatory ventilation combined with intermittent sigh breaths: Effects on lung volume monitored by electric tomography impedance [Internet]","author":"Heiring","year":"2023"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2478\/abm-2022-0034"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24335"}],"container-title":["Clinical and Experimental Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2024-01011.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2024.01011","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2024-01011.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T05:47:47Z","timestamp":1738561667000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2024.01011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,15]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"URL":"https:\/\/doi.org\/10.3345\/cep.2024.01011","relation":{},"ISSN":["2713-4148"],"issn-type":[{"value":"2713-4148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,15]]},"assertion":[{"value":"2024-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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