High Frequency Oscillating Ventilation (HFOV) in Severe Acute Respiratory Distress Syndrome (ARDS): A Case Report

High frequency oscillating ventilation (HFOV) provides a rescue therapy for patients with refractory hypoxaemia in severe acute respiratory distress syndrome (ARDS). HFOV utilizes high mean airway pressures to maintain an open lung and low tidal volumes at a high frequency that allows for adequate ventilation while at the same time preventing alveolar overdistension. This seems to be an ideal lung protective ventilation strategies to prevent ventilator-induced lung injury (VILI)2. We reported a case of severe extrapulmonary ARDS secondary to acute lymphoblastic leukaemia responding to the use of HFOV.

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Combining High-Frequency Oscillatory Ventilation and Recruitment Maneuvers in Adults With Early Acute Respiratory Distress Syndrome: The Treatment With Oscillation and an Open Lung Strategy (TOOLS) Trial Pilot Study

Yearbook of Pulmonary Disease ◽

10.1016/s8756-3452(08)70231-7 ◽

2006 ◽

Vol 2006 ◽

pp. 285-286

Author(s):

J.A. Barker

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Pilot Study ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

High Frequency ◽

Distress Syndrome ◽

High Frequency Oscillatory Ventilation ◽

Open Lung ◽

Recruitment Maneuvers ◽

High Frequency Oscillatory

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Optimal Ventilator Strategies in Acute Respiratory Distress Syndrome

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0039-1683896 ◽

2019 ◽

Vol 40 (01) ◽

pp. 081-093 ◽

Cited By ~ 1

Author(s):

Michael Sklar ◽

Bhakti Patel ◽

Jeremy Beitler ◽

Thomas Piraino ◽

Ewan Goligher

Keyword(s):

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

High Frequency ◽

Distress Syndrome ◽

Rescue Therapy ◽

High Frequency Oscillation ◽

Respiratory Drive ◽

Hypoxemic Respiratory Failure

AbstractMechanical ventilation practices in patients with acute respiratory distress syndrome (ARDS) have progressed with a growing understanding of the disease pathophysiology. Paramount to the care of affected patients is the delivery of lung-protective mechanical ventilation which prioritizes tidal volume and plateau pressure limitation. Lung protection can probably be further enhanced by scaling target tidal volumes to the specific respiratory mechanics of individual patients. The best procedure for selecting optimal positive end-expiratory pressure (PEEP) in ARDS remains uncertain; several relevant issues must be considered when selecting PEEP, particularly lung recruitability. Noninvasive ventilation must be used with caution in ARDS as excessively high respiratory drive can further exacerbate lung injury; newer modes of delivery offer promising approaches in hypoxemic respiratory failure. Airway pressure release ventilation offers an alternative approach to maximize lung recruitment and oxygenation, but clinical trials have not demonstrated a survival benefit of this mode over conventional ventilation strategies. Rescue therapy with high-frequency oscillatory ventilation is an important option in refractory hypoxemia. Despite a disappointing lack of benefit (and possible harm) in patients with moderate or severe ARDS, possibly due to lung hyperdistention and right ventricular dysfunction, high-frequency oscillation may improve outcome in patients with very severe hypoxemia.

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