title: High-frequency oscillatory ventilation in children with acute respiratory distress syndrome: experience of a pediatric intensive care unit.
abstract: OBJECTIVE
  To describe the effects of high-frequency oscillatory ventilation (HFOV) as a rescue ventilatory support in pediatric patients with acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  Twenty-five children (1 month < age < 17 years) admitted to a university hospital pediatric intensive care unit (ICU) with ARDS and submitted to HFOV for a minimum of 48 hours after failure of conventional mechanical ventilation were assessed.
  
  
  RESULTS
  Twenty eight days after the onset of ARDS, the mortality rate was 52% (13/25). Over the course of 48 hours, the use of HFOV reduced the oxygenation index [38 (31-50) vs. 17 (10-27)] and increased the ratio of partial arterial pressure O2 and fraction of inspired O2 [65 [44-80) vs. 152 (106-213)]. Arterial CO2 partial pressure [54 (45-74) vs. 48 (39-58) mmHg] remained unchanged. The mean airway pressure ranged between 23 and 29 cmH2O. HFOV did not compromise hemodynamics, and a reduction in heart rate was observed (141±32 vs. 119±22 beats/min), whereas mean arterial pressure (66±20 vs. 71±17 mmHg) and inotropic score [44 (17-130) vs. 20 (16-75)] remained stable during this period. No survivors were dependent on oxygen.
  
  
  CONCLUSIONS
  HFOV improves oxygenation in pediatric patients with ARDS and severe hypoxemia refractory to conventional ventilatory support.
authors.affiliation: Pediatric Intensive Care Unit, Hospital de Criança Santo Antonio, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil.
authors.forename: Anelise Dentzien
authors.initials: AD
authors.lastname: Pinzon
authors.forename: Taís Sica da
authors.initials: TS
authors.lastname: Rocha
authors.forename: Cláudia
authors.initials: C
authors.lastname: Ricachinevsky
authors.forename: Jefferson Pedro
authors.initials: JP
authors.lastname: Piva
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006612:High-Frequency Ventilation / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute respiratory distress syndrome; High frequency oscillatory ventilation; Insuficiência respiratória; Pediatria; Pediatrics; Protective mechanical ventilation; Respiratory failure; Síndrome da angústia respiratória aguda; Ventilação de alta frequência oscilatória; Ventilação mecânica protetora