High-frequency percussive ventilation.
OBJECTIVE
To review the technique and clinical application of high-frequency percussive ventilation in critically ill patients.


METHODS
Literature search and descriptive review.


RESULTS
High-frequency percussive ventilation is a time-cycled, pressure-limited mode of ventilation that delivers subphysiologic tidal volumes at rates that can exceed 500 breaths/min. It offers the potential advantage over conventional ventilation of providing equal or improved oxygenation and ventilation at lower peak and end-expiratory pressures. This modality has been used to manage severe lung disease in the neonatal and pediatric population, treat inhalation injury in pediatric and adult patients, and as salvage therapy in adult patients with acute respiratory distress syndrome.


CONCLUSIONS
High-frequency percussive ventilation has been shown to provide favorable gas exchange in several well-defined patient populations. It reliably improves oxygenation and provides adequate ventilation at lower peak pressures than conventional ventilation. Adequately powered, randomized, prospective studies demonstrating significant mortality benefit have not yet been performed.
Salim
Ali
A
Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine, USA.
Martin
Matthew
M
D000328:Adult; D016638:Critical Illness; D004867:Equipment Design; D006612:High-Frequency Ventilation / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D012128:Respiratory Distress Syndrome / Q000628:therapy; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy