High-Frequency Oscillatory Ventilation and High-Flow Nasal Cannula in a Child with Hepatoblastoma and Severe Respiratory Failure: Case Report
DOI:
https://doi.org/10.32635/2176-9745.RBC.2026v72n4.5703Keywords:
Hepatoblastoma, High-Frequency Ventilation/methods, Respiratory Failure/complications, Pediatric Intensive Care Units, Child, PreschoolAbstract
Introduction: Hepatoblastoma is the most common malignant liver neoplasm in childhood and can present with significant respiratory repercussions. In severe cases, lung-protective ventilatory strategies are essential, and the physiological mechanisms that support these interventions are discussed. The objective is to describe the ventilatory management and clinical evolution of a child with hepatoblastoma and severe respiratory failure undergoing high-frequency oscillatory ventilation (HFOV) and high-flow nasal cannula (HFNC), discussing the physiological basis and applicability of these strategies. Case report: A 2-year-old child with a large hepatoblastoma undergoing chemotherapy developed severe respiratory failure, hypercapnia, and marked acidemia that were refractory to conventional ventilation, prompting initiation of HFOV. After stabilization, a planned transition to conventional ventilation was performed, followed by the use of HFNC after accidental extubation, without the need for reintubation, which resulted in a favorable outcome. Conclusion: HFOV combined with the strategic use of HFNC may represent a safe and effective alternative for children with hepatoblastoma and severe respiratory impairment secondary to abdominal compression and treatment-related complications.
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