title: High-frequency percussive ventilation in severe acute respiratory distress syndrome: A single center experience.
abstract: BACKGROUND
  Few studies have investigated high-frequency percussive ventilation (HFPV) in adult patients with acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  We retrospectively analyzed data from critically ill-patients with moderate and severe ARDS who received HFPV. Ventilation and oxygenation were governed according to a predefined protocol. HFPV was continued until patients could be switched to conventional ventilation.
  
  
  RESULTS
  A total of 42 patients (20 with pneumonia-related ARDS and 22 non-septic ARDS cases) were evaluable. Baseline demographic characteristics, severity of illness, lung injury score; pH and respiratory variables were comparable between pneumonia and non-sepsis-related ARDS. Within 24 h, HFPV restored normal pH and PaCO2 and considerably improved oxygenation. Oxygenation improved more in non-septic than in pneumonia-related ARDS. Patients with pneumonia-induced ARDS also remained longer HFPV-dependent (7.0 vs. 4.9 days; P < 0.05). Mortality at 30 days was significantly higher in pneumonia-related than in non-sepsis-related ARDS (50% vs. 18%; P = 0.01).
  
  
  CONCLUSIONS
  HFPV caused rapid and sustained improvement of oxygenation and ventilation in patients with moderate to severe ARDS. Less improved oxygenation, longer ventilator dependency and worse survival were observed in pneumonia-related ARDS.
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Herbert
authors.initials: H
authors.lastname: Spapen
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Marianne
authors.initials: M
authors.lastname: Borremans
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Diltoer
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Viola Van
authors.initials: VV
authors.lastname: Gorp
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Duc Nam
authors.initials: DN
authors.lastname: Nguyen
authors.affiliation: Department of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Honoré
keywords: Acute respiratory distress syndrome; high-frequency percussive ventilation; pneumonia