title: High-frequency percussive ventilation: a new strategy for separation from extracorporeal membrane oxygenation.
abstract: We report the case of a 48-year-old woman who developed severe septic shock and lung injury after community-acquired pneumonia. She was supported on arteriovenous extracorporeal membrane oxygenation (ECMO) for 19 days. To facilitate decannulation and separation from ECMO, we began trials of high-frequency percussive ventilation (HFPV) using the volumetric diffusive respiration ventilator VDR-4 (Percussionaire Corp, Sandpoint, Idaho) for 4 consecutive days (1 before and 3 after). Decannulation was achieved successfully, and the patient was transferred to the floor 3 months later. During the 4 days of HFPV, the chest radiograph improved, as did gas exchange and clearance of pulmonary secretions. HFPV may be a promising strategy for improving lung recruitment and airway clearance during separation from ECMO in the critically ill patient.
authors.affiliation: From the Department of Medicine, Anesthesia, and Intensive Care Unit, Padova University Hospital, Padua, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Boscolo
authors.forename: Arianna
authors.initials: A
authors.lastname: Peralta
authors.forename: Fabio
authors.initials: F
authors.lastname: Baratto
authors.forename: Sandra
authors.initials: S
authors.lastname: Rossi
authors.forename: Carlo
authors.initials: C
authors.lastname: Ori
mesh_terms: D016638:Critical Illness; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006612:High-Frequency Ventilation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*; D012772:Shock, Septic / Q000209:etiology