High-Frequency Oscillatory Ventilation


Technique

Indications

Contraindications

Side effects

Protocol

Note

High-frequency oscillatory ventilation (HFOV)

Acute respiratory distress syndrome with hypoxemia refractory to conventional protective ventilation

Recent lung surgery, lung disease characterized by airway narrowing or air trapping, intracranial hypertension

Increased mean airway pressures, use of vasoactive drugs, neuromuscular blockers, and sedatives

Initial meanairway pressureof 30 cm H2O,later adjustedto maintainPaO2 55–80 mmHg.HFOV tidal volumesreduced using thehighest frequencyfor maintainingpH >7.25

Increases mortality compared to protective lung ventilation, avoid first-line use





References



1.

Ware LB, Matthay MA (2000) The acute respiratory distress syndrome. N Engl J Med 342:1334–1349CrossRefPubMed


2.

Webb H, Tierney D (1974) Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures: protection by positive endexpiratory pressure. Am Rev Respir Dis 110:556–565PubMed


3.

Dreyfuss D, Basset G, Soler P, Saumon G (1985) Intermittent positive-pressure hyperventilation with high inflation pressures produces pulmonary microvascular injury in rats. Am Rev Respir Dis 132:880–884PubMed


4.

Dreyfuss D, Saumon G (1998) Ventilator-induced lung injury: lessons from experimental studies. Am J Respir Crit Care Med 157:294–323CrossRefPubMed


5.

The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342(18):1301–1308CrossRef


6.

Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi- Filho G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CR (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338:347–354CrossRefPubMed


7.

Villar J, Pérez-Méndez L, Blanco J, Añón JM, Blanch L, Belda J, Santos-Bouza A, Fernández RL, Kacmarek RM, Spanish Initiative for Epidemiology, Stratification, and Therapies for ARDS (SIESTA) Network (2013) A universal definition of ARDS: the PaO2/FiO2 ratio under a standard ventilatory setting–a prospective, multicenter validation study. Intensive Care Med 39(4):583–592CrossRefPubMed

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May 9, 2017 | Posted by in CRITICAL CARE | Comments Off on High-Frequency Oscillatory Ventilation

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