title: High-frequency oscillatory ventilation for patients during exudative phase of severe ARDS.
abstract: BACKGROUND
  High frequency oscillatory ventilation (HFOV) is theoretically ideal for lung protective strategy ventilation (LPSV) in acute respiratory distress syndrome (ARDS). However, recent studies revealed unsatisfactory outcomes. The authors conducted a study to examine this phenomenon in patients with early phase of moderate to severe ARDS.
  
  
  OBJECTIVE
  To evaluate the effectiveness of HFOV in patients with early phase of moderate to severe ARDS. The primary outcome was 30 days all-cause mortality.
  
  
  METHODS
  The study was a matched-case controlled clinical trial performed in the medical intensive care units, Faculty of Medicine, Siriraj Hospital. The authors compared HFOV with LPSV in adult patients with the early phase of ARDS who received mechanical ventilation less than 72 hours and had moderate to severe hypoxemia (PaO/FiO2 ratio less than or equal 150).
  
  
  RESULTS
  Between June 2010 and February 2014, 49 patients with moderate to severe ARDS were included. Fourteen patients who received HFOV were matched with 16 patients who received LPSV. The 30-day mortality in HFOV group was 61.5%; while in control group, 50% (p = 0.53). The authors found use of higher doses of sedative drugs and muscle relaxants in HFOV group. In addition, this group had high-level of mean airway pressure (mPaw). The presence of hemodynamic instability was not different in both groups.
  
  
  CONCLUSIONS
  In adult patients in the early phase of moderate to severe ARDS who received mechanical ventilation for less than 72 hours, HFOV did not decrease the 30-day mortality. Thus, this support should be only a rescue therapy for refractory hypoxemia cases and in highly selected patients.
authors.forename: Thummaporn
authors.initials: T
authors.lastname: Naorungroj
authors.forename: Warakarn
authors.initials: W
authors.lastname: Vilaichone
authors.forename: Surat
authors.initials: S
authors.lastname: Tongyoo
authors.forename: Preecha
authors.initials: P
authors.lastname: Thamrongpairoj
authors.forename: Chairat
authors.initials: C
authors.lastname: Permpikul
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006612:High-Frequency Ventilation / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D013997:Time Factors