Is there still a role for high-frequency oscillatory ventilation in neonates, children and adults?
Critically ill patients with respiratory pathology often require mechanical ventilation and while low tidal volume ventilation has become the mainstay of treatment, achieving adequate gas exchange may not be attainable with conventional ventilator modalities. In attempt to achieve gas exchange goals and also mitigate lung injury, high frequency ventilation is often implemented which couples low tidal volumes with sustained mean airway pressure. This manuscript presents the physiology of high-frequency oscillatory ventilation, reviews the currently available data on its use and provides strategies and approaches for this mode of ventilation.
Susan R
SR
Hupp
a Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
David A
DA
Turner
a Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
Kyle J
KJ
Rehder
D000328:Adult; D002648:Child; D016638:Critical Illness / Q000628:therapy*; D006439:Hemodynamics; D006612:High-Frequency Ventilation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D055370:Lung Injury / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012128:Respiratory Distress Syndrome; D015300:Ventilator Weaning / Q000379:methods
acute respiratory distress syndrome; high frequency; high-frequency oscillatory ventilation; mechanical ventilation; pediatric; ventilator-induced lung injury