Use of ultrahigh frequency ventilation in patients with ARDS. A preliminary report.
OBJECTIVE
Our objective was to compare the efficacy of ultrahigh frequency ventilation (UHFV) (frequencies > 3 Hz) with respect to oxygenation, airway pressures, and hemodynamic parameters in patients with adult respiratory distress syndrome (ARDS) who were not responding to conventional ventilation.


METHODS
We used a prospective, multicenter, nonrandomized study design in which each patient served as his own control.


METHODS
Three university-affiliated, tertiary-care medical centers participated.


METHODS
Persons aged 16 to 79 years old with ARDS and unresponsive to conventional ventilation, as defined by a Food and Drug Administration (FDA) approved protocol, were included.


METHODS
Ninety patients who were not responding to conventional ventilation were changed to UHFV using a microcomputer-controlled device.


RESULTS
The patient's blood gas, hemodynamic, and airway pressure variables were measured just before, and at 1 and 24 h after the switch to UHFV. We demonstrated clinically significant improvements in arterial oxygen tension (PaO2) and reductions in peak and mean inspiratory pressures.


CONCLUSIONS
In a multicenter study, UHFV improved respiratory gas exchange and reduced airway pressure variables at both 1 h and 24 h after the onset of UHFV when compared with conventional ventilation just prior to the change and without hemodynamic deterioration, in patients with severe ARDS.
Gluck
E
E
Section of Pulmonary and Critical Care, Rush-Presbyterian-St. Luke's Hospital, Chicago.
Heard
S
S
Patel
C
C
Mohr
J
J
Calkins
J
J
Fink
M P
MP
Landow
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011312:Pressure; D011446:Prospective Studies; D012123:Pulmonary Ventilation / Q000502:physiology; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D010100:Oxygen