title: High-frequency oscillatory ventilation for acute respiratory distress syndrome.
abstract: OBJECTIVE
  To evaluate the effectiveness of HFOV in pediatric patients with acute respiratory distress syndrome.
  
  
  METHODS
  In this retrospective study, we reviewed all 20 pediatric patients, who were consecutively ventilated with HFOV in the pediatric intensive care unit of a tertiary medical center, from January 2006 to February 2007.
  
  
  RESULTS
  A total of 20 patients were enrolled. The median age of the subjects was 70 (3-168) months; 10 were male. All patients received conventional ventilation before HFOV. After initiation of HFOV, there was an immediate and sustained increase in PaO(2)/FiO(2) ratio. The PaO(2)/FiO(2) ratio was elevated and OI was decreased significantly after 10-20 minutes and maintained for at least 48 hours (p= 0.03, both). Thirteen of the 20 patients were successfully weaned. No significant change in the mean arterial pressure and heart rate was noted after HFOV. Overall survival rate was 65%. Of 20 patients, 11 patients suffered from extrapulmonary ARDS (ARDSexp) and 9 from pulmonary ARDS (ARDSp). When HFOV was initiated, there was significant increase in PaO(2)/FiO(2) and decrease in OI in ARDSexp compared to ARDSp (p= 0.03, both). Also mortality rate was significantly lower in patients with ARDSexp (9% vs.66%), (p= 0.01).
  
  
  CONCLUSIONS
  In our study, HFOV was effective in oxygenation and seems to be safe for pediatric ARDS patients. HFOV affected ARDSp and ARDSexp paediatric patients differently. However prospective, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.
authors.affiliation: Cukurova University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Adana, Turkey. dyildizdas@cu.edu.tr
authors.forename: Dincer
authors.initials: D
authors.lastname: Yildizdas
authors.forename: Hacer
authors.initials: H
authors.lastname: Yapicioglu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Bayram
authors.forename: Levent
authors.initials: L
authors.lastname: Yilmaz
authors.forename: Yasar
authors.initials: Y
authors.lastname: Sertdemir
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology