Document Detail

High-frequency oscillatory ventilation for adult patients with ARDS.
MedLine Citation:
PMID:  17565024     Owner:  NLM     Status:  MEDLINE    
High-frequency oscillatory ventilation (HFOV) is characterized by the rapid delivery of small tidal volumes (Vts) of gas and the application of high mean airway pressures (mPaws). These characteristics make HFOV conceptually attractive as an ideal lung-protective ventilatory mode for the management of ARDS, as the high mPaws prevent cyclical derecruitment of the lung and the small Vts limit alveolar overdistension. In this review, we will summarize the literature describing the use of HFOV in adult patients with ARDS. In addition, we will discuss recent experimental studies of HFOV that have advanced our understanding of its mechanical properties. We identified 2 randomized controlled trials (RCTs) and 12 case series evaluating HFOV in adults with ARDS. In these studies, HFOV appears to be safe and consistently improves oxygenation when used as a rescue mode of ventilation in patients with severe ARDS. The two RCTs comparing HFOV to conventional ventilation revealed encouraging results but failed to show a mortality benefit of HFOV over conventional ventilation. Further research is needed to identify optimal patient selection, technique, the actual Vt delivered, and the role of combining HFOV with other interventions, such as recruitment maneuvers, prone positioning, and nitric oxide.
Kenneth P W Chan; Thomas E Stewart; Sangeeta Mehta
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Chest     Volume:  131     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-13     Completed Date:  2007-08-16     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1907-16     Citation Subset:  AIM; IM    
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
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MeSH Terms
High-Frequency Ventilation / adverse effects,  methods*
Lung / physiopathology
Lung Injury
Pulmonary Gas Exchange / physiology
Respiratory Distress Syndrome, Adult / physiopathology,  therapy*
Respiratory Mechanics / physiology

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