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.
Playfor
Stephen D
SD
Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Manchester, UK. Stephen.playfor@cmmc.nhs.uk
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