title: High-frequency oscillatory ventilation as a rescue therapy for adult trauma patients.
abstract: BACKGROUND
  High-frequency oscillatory ventilation is an alternative ventilation mode that improves oxygenation in trauma patients in whom conventional ventilation strategies have been unsuccessful.
  
  
  OBJECTIVE
  To evaluate the effect of high-frequency oscillatory ventilation on oxygenation, survival, and parameters predictive of survival in trauma patients.
  
  
  METHODS
  A retrospective case series of 24 adult patients admitted to the trauma intensive care unit at a level I trauma center between November 2001 and July 2005 and treated with high-frequency oscillatory ventilation. Survivors and nonsurvivors were compared for mechanism and severity of injury, oxygenation parameters related to high-frequency oscillatory ventilation, and hospital course.
  
  
  RESULTS
  Of the 8577 patients admitted during the study period, acute respiratory distress syndrome developed in 103 (1%). Of those 103 patients, 24 (23%) were treated with high-frequency oscillatory ventilation. Most of the patients treated with high-frequency oscillatory ventilation had sustained blunt trauma (79%). Oxygenation parameters improved significantly with high-frequency oscillatory ventilation in all patients, regardless of survival. Of the 24 patients treated with this ventilation mode, 15 (62%) survived. Survival did not correlate with improved oxygenation parameters but with the number of failed organ systems and injury severity.
  
  
  CONCLUSIONS
  Although high-frequency oscillatory ventilation improves oxygenation, severity of traumatic injury and organ failure, not respiratory parameters, are predictors of survival. High-frequency oscillatory ventilation should be considered for pulmonary rescue of severely injured patients with acute respiratory distress syndrome.
authors.affiliation: Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, North Carolina 27858-4354, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Briggs
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Goettler
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Schenarts
authors.forename: Mark A
authors.initials: MA
authors.lastname: Newell
authors.forename: Scott G
authors.initials: SG
authors.lastname: Sagraves
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bard
authors.forename: Eric A
authors.initials: EA
authors.lastname: Toschlog
authors.forename: Michael F
authors.initials: MF
authors.lastname: Rotondo
mesh_terms: D001784:Blood Gas Analysis; D006612:High-Frequency Ventilation / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D012189:Retrospective Studies; D016019:Survival Analysis; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy*