The role of high-frequency oscillatory ventilation in paediatric intensive care.
Mechanical ventilation during acute respiratory failure in children is associated with development of ventilator-induced lung injury. Experimental models of mechanical ventilation that limit phasic changes in lung volumes and prevent alveolar overdistension appear to be less damaging to the lung. High-frequency oscillatory ventilation, using very small tidal volumes and relatively high end-expiratory lung volumes, provides a safe and effective means of delivering mechanical ventilatory support with the prospect of reducing the development of ventilator-induced lung injury. Despite theoretical advantages and convincing laboratory data, however, the use of high-frequency oscillatory ventilation in the paediatric population has not yet been associated with significant improvements in clinically significant outcome measures.
Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Manchester, UK. Stephen.playfor@cmmc.nhs.uk
Stephen D
SD
Playfor
D002648:Child; D002675:Child, Preschool; D006612:High-Frequency Ventilation; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D010372:Pediatrics; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate