high frequency ventilation

Summary

Summary: Ventilatory support system using frequencies from 60-900 cycles/min or more. Three types of systems have been distinguished on the basis of rates, volumes, and the system used. They are high frequency positive-pressure ventilation (HFPPV); HIGH-FREQUENCY JET VENTILATION; (HFJV); and high-frequency oscillation (HFO).

Top Publications

  1. Pillow J. High-frequency oscillatory ventilation: mechanisms of gas exchange and lung mechanics. Crit Care Med. 2005;33:S135-41 pubmed
    ..Monitoring of lung volume, respiratory mechanics, and ventilation homogeneity may facilitate individual optimization of HFOV ventilatory settings in the future. ..
  2. Durand D, Asselin J, Hudak M, Aschner J, McArtor R, Cleary J, et al. Early high-frequency oscillatory ventilation versus synchronized intermittent mandatory ventilation in very low birth weight infants: a pilot study of two ventilation protocols. J Perinatol. 2001;21:221-9 pubmed
    ..The protocols for the ventilator management of VLBW infants, both with HFOV and with SIMV were easily implemented and consistently followed, and are presented here. ..
  3. Bollen C, Uiterwaal C, van Vught A. Cumulative metaanalysis of high-frequency versus conventional ventilation in premature neonates. Am J Respir Crit Care Med. 2003;168:1150-5 pubmed
  4. van Kaam A, Haitsma J, Dik W, Naber B, Alblas E, De Jaegere A, et al. Response to exogenous surfactant is different during open lung and conventional ventilation. Crit Care Med. 2004;32:774-80 pubmed
    ..Surfactant conversion during open lung ventilation is reduced compared with PPVCON. Exogenous surfactant seems to up-regulate bronchoalveolar lavage interleukin-8 concentrations, independent of the ventilation strategy. ..
  5. Ventre K, Arnold J. High frequency oscillatory ventilation in acute respiratory failure. Paediatr Respir Rev. 2004;5:323-32 pubmed
    ..Use of HFOV in the paediatric and adult populations has not as yet been associated with significant improvements in clinically important outcome measures. ..
  6. Chan K, Stewart T. Clinical use of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome. Crit Care Med. 2005;33:S170-4 pubmed
    ..However, we believe that such a trial should wait until we have a better understanding of HFOV in adults. ..
  7. Sessler C. Sedation, analgesia, and neuromuscular blockade for high-frequency oscillatory ventilation. Crit Care Med. 2005;33:S209-16 pubmed
    ..A multidisciplinary, structured approach that is based on the considerations described should help achieve optimal results in this challenging patient population. ..
  8. Thome U, Carlo W, Pohlandt F. Ventilation strategies and outcome in randomised trials of high frequency ventilation. Arch Dis Child Fetal Neonatal Ed. 2005;90:F466-73 pubmed
    Randomised controlled trials comparing elective use of high frequency ventilation (HFV) with conventional mechanical ventilation (CMV) in preterm infants have yielded conflicting results...
  9. van Heerde M, van Genderingen H, Leenhoven T, Roubik K, Plötz F, Markhorst D. Imposed work of breathing during high-frequency oscillatory ventilation: a bench study. Crit Care. 2006;10:R23 pubmed
    ..A high fresh gas flow rate reduced the imposed WOB. These findings suggest the need for a demand flow system based on patient need allowing spontaneous breathing during HFOV. ..

More Information

Publications62

  1. Slutsky A, Drazen J. Ventilation with small tidal volumes. N Engl J Med. 2002;347:630-1 pubmed
  2. Ferguson N, Stewart T. New therapies for adults with acute lung injury. High-frequency oscillatory ventilation. Crit Care Clin. 2002;18:91-106 pubmed
    ..Future research may define the role of HFOV as a more routine strategy for preventing VALI in this patient population. ..
  3. Dobyns E, Anas N, Fortenberry J, Deshpande J, Cornfield D, Tasker R, et al. Interactive effects of high-frequency oscillatory ventilation and inhaled nitric oxide in acute hypoxemic respiratory failure in pediatrics. Crit Care Med. 2002;30:2425-9 pubmed
    ..We speculate that the enhanced lung recruitment by HFOV enhances the effects of low dose iNO on gas exchange. ..
  4. van Kaam A, De Jaegere A, Haitsma J, van Aalderen W, Kok J, Lachmann B. Positive pressure ventilation with the open lung concept optimizes gas exchange and reduces ventilator-induced lung injury in newborn piglets. Pediatr Res. 2003;53:245-53 pubmed
    ..These beneficial effects are comparable to HFOV. ..
  5. Mehta S, MacDonald R, Hallett D, Lapinsky S, Aubin M, Stewart T. Acute oxygenation response to inhaled nitric oxide when combined with high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome. Crit Care Med. 2003;31:383-9 pubmed
    ..40 +/- 17, p=.08). INO delivered at doses of 5 to 20 ppm during high-frequency oscillatory ventilation increases Pao2/Fio2 and may be a safe and effective rescue therapy for patients with severe oxygenation failure. ..
  6. van Genderingen H, van Vught J, Jansen J, Duval E, Markhorst D, Versprille A. Oxygenation index, an indicator of optimal distending pressure during high-frequency oscillatory ventilation?. Intensive Care Med. 2002;28:1151-6 pubmed
    ..05) during deflation. In 15 out of the 16 comparisons, the difference in Paw was within one step (+/-3 cmH(2)O). The minimal OI is indicative for the Paw where oxygenation is optimal during HFOV in surfactant-depleted pigs. ..
  7. Johnson A, Peacock J, Greenough A, Marlow N, Limb E, Marston L, et al. High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity. N Engl J Med. 2002;347:633-42 pubmed
    ..Assessment of long-term effects will require additional follow-up. ..
  8. Ferguson N, Chiche J, Kacmarek R, Hallett D, Mehta S, Findlay G, et al. 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. Crit Care Med. 2005;33:479-86 pubmed
    ..This explicit high-frequency oscillatory ventilation protocol appears well tolerated, feasible, and physiologically sound. ..
  9. Mehta S, Lapinsky S, Hallett D, Merker D, Groll R, Cooper A, et al. Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome. Crit Care Med. 2001;29:1360-9 pubmed
    ..In addition, early institution of HFOV may be advantageous. ..
  10. Tingay D, Mills J, Morley C, Pellicano A, Dargaville P. Trends in use and outcome of newborn infants treated with high frequency ventilation in Australia and New Zealand, 1996-2003. J Paediatr Child Health. 2007;43:160-6 pubmed
    To examine the use of high frequency ventilation (HFV) to treat newborn infants in Australia and New Zealand and the associated complications and outcomes...
  11. David M, Weiler N, Heinrichs W, Neumann M, Joost T, Markstaller K, et al. High-frequency oscillatory ventilation in adult acute respiratory distress syndrome. Intensive Care Med. 2003;29:1656-65 pubmed
    ..HFOV is an effective and safe method to ventilate ARDS patients. Failure to improve oxygenation within 24 h of HFOV is associated with high mortality. ..
  12. van Genderingen H, van Vught A, Jansen J. Regional lung volume during high-frequency oscillatory ventilation by electrical impedance tomography. Crit Care Med. 2004;32:787-94 pubmed
    ..HFOV has a homogenizing effect on lung volume distribution. Regional lung volume distribution can be assessed using electrical impedance tomography. However, thoracic fluid accumulation may complicate its interpretation. ..
  13. Craft A, Bhandari V, Finer N. The sy-fi study: a randomized prospective trial of synchronized intermittent mandatory ventilation versus a high-frequency flow interrupter in infants less than 1000 g. J Perinatol. 2003;23:14-9 pubmed
    ..There was no significant difference in the ventilator days or BPD, defined as oxygen requirement at 36 weeks postmenstrual age, between the high-frequency ventilation and SIMV groups. ..
  14. Bollen C, van Well G, Sherry T, Beale R, Shah S, Findlay G, et al. High frequency oscillatory ventilation compared with conventional mechanical ventilation in adult respiratory distress syndrome: a randomized controlled trial [ISRCTN24242669]. Crit Care. 2005;9:R430-9 pubmed
    ..More research is needed to establish the efficacy of HFOV in the treatment of ARDS. We suggest that future studies are designed to allow for informative analysis in patients with higher OI. ..
  15. Slee Wijffels F, van der Vaart K, Twisk J, Markhorst D, Plötz F. High-frequency oscillatory ventilation in children: a single-center experience of 53 cases. Crit Care. 2005;9:R274-9 pubmed
    ..Patients with SAD primarily had severe hypercapnia and HFOV therapy was very effective in achieving adequate ventilation. ..
  16. von der Hardt K, Kandler M, Fink L, Schoof E, Dotsch J, Brandenstein O, et al. High frequency oscillatory ventilation suppresses inflammatory response in lung tissue and microdissected alveolar macrophages in surfactant depleted piglets. Pediatr Res. 2004;55:339-46 pubmed
    ..3 +/- 0.3 versus 2.8 +/- 1.0; vascular smooth muscle cells: 0.7 +/- 0.3 versus 1.1 +/- 0.4). In conclusion, HFOV improved oxygenation, reduced pulmonary arterial pressure and attenuated pulmonary inflammatory response. ..
  17. Andersen F, Guttormsen A, Flaatten H. High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome--a retrospective study. Acta Anaesthesiol Scand. 2002;46:1082-8 pubmed
    ..Survival at 3 months was 68.8%. HFOV effectively improves oxygenation without haemodynamic compromise. During HFOV, the SOFA score may predict outcome. ..
  18. Ng G, Derry C, Marston L, Choudhury M, Holmes K, Calvert S. Reduction in ventilator-induced lung injury improves outcome in congenital diaphragmatic hernia?. Pediatr Surg Int. 2008;24:145-50 pubmed
    ..The survival results for CDH at St George's Hospital are comparable to those published from other institutions. The results may reflect a reduction in ventilator-induced lung injury with HFOV compared to CMV...
  19. Van Reempts P, Borstlap C, Laroche S, van der Auwera J. Early use of high frequency ventilation in the premature neonate. Eur J Pediatr. 2003;162:219-26 pubmed
    This study evaluated whether the early use of high frequency ventilation (HFV) decreased the incidence of oxygen dependency at 36 weeks postconceptual age [chronic lung disease (CLD)] and improved developmental outcome...
  20. Tingay D, Mills J, Morley C, Pellicano A, Dargaville P. The deflation limb of the pressure-volume relationship in infants during high-frequency ventilation. Am J Respir Crit Care Med. 2006;173:414-20 pubmed
    ..It is possible to delineate the deflation limb in infants receiving high-frequency oscillatory ventilation; in doing so, greater lung volume and oxygenation can be achieved, often at lower airway pressures. ..
  21. Capoluongo E, Vento G, Santonocito C, Matassa P, Vaccarella C, Giardina B, et al. Comparison of serum levels of seven cytokines in premature newborns undergoing different ventilatory procedures: high frequency oscillatory ventilation or synchronized intermittent mandatory ventilation. Eur Cytokine Netw. 2005;16:199-205 pubmed
  22. Imai Y, Slutsky A. High-frequency oscillatory ventilation and ventilator-induced lung injury. Crit Care Med. 2005;33:S129-34 pubmed
  23. Cartotto R, Ellis S, Gomez M, Cooper A, Smith T. High frequency oscillatory ventilation in burn patients with the acute respiratory distress syndrome. Burns. 2004;30:453-63 pubmed
    ..The purpose of this study was to review our experience with HFOV in adult burn patients with oxygenation failure secondary to ARDS...
  24. Scalfaro P, Pillow J, Sly P, Cotting J. Reliable tidal volume estimates at the airway opening with an infant monitor during high-frequency oscillatory ventilation. Crit Care Med. 2001;29:1925-30 pubmed
  25. Anton N, Joffe K, Joffe A. Inability to predict outcome of acute respiratory distress syndrome in children when using high frequency oscillation. Intensive Care Med. 2003;29:1763-9 pubmed
    ..Survival was significantly better than predicted by the Pediatric Respiratory Failure score. A prospective randomized controlled trial of HFO in ARDS is warranted. ..
  26. Ritacca F, Stewart T. Clinical review: high-frequency oscillatory ventilation in adults--a review of the literature and practical applications. Crit Care. 2003;7:385-90 pubmed
    ..The present article reviews the principles and practical aspects of HFOV, and the current evidence for its application in adults with ARDS. ..
  27. Papazian L, Gainnier M, Marin V, Donati S, Arnal J, Demory D, et al. Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome. Crit Care Med. 2005;33:2162-71 pubmed
    ..Prone-HFOV produced similar improvement in oxygenation like prone-CV but was associated with higher BALF indexes of inflammation. In contrast, supine-HFOV did not improve gas exchange and was associated with enhanced lung inflammation. ..
  28. Pachl J, Roubik K, Waldauf P, Fric M, Zabrodsky V. Normocapnic high-frequency oscillatory ventilation affects differently extrapulmonary and pulmonary forms of acute respiratory distress syndrome in adults. Physiol Res. 2006;55:15-24 pubmed
    ..01). HFOV recruits and thus it is more effective in ARDS(exp). ARDS(exp) patients require higher CDP levels than ARDS(p) patients. The testing period for positive effect of HFOV is recommended not to be longer than 24 hours. ..
  29. Mehta S, Granton J, MacDonald R, Bowman D, Matte Martyn A, Bachman T, et al. High-frequency oscillatory ventilation in adults: the Toronto experience. Chest. 2004;126:518-27 pubmed
    ..HFOV has beneficial effects on Pao(2)/Fio(2) ratios and OI, and may be an effective rescue therapy for adults with severe oxygenation failure. The early institution of HFOV may be advantageous. ..
  30. Bollen C, Uiterwaal C, van Vught A. Meta-regression analysis of high-frequency ventilation vs conventional ventilation in infant respiratory distress syndrome. Intensive Care Med. 2007;33:680-8 pubmed
    ..We investigated what factors explained differences in outcome among these trials...
  31. van Heerde M, Roubik K, Kopelent V, Plötz F, Markhorst D. Unloading work of breathing during high-frequency oscillatory ventilation: a bench study. Crit Care. 2006;10:R103 pubmed
    ..Early initiation of HFOV seems more possible with this system and the possibility of weaning of patients directly on a high-frequency oscillatory ventilator is not excluded either. ..
  32. Courtney S, Durand D, Asselin J, Hudak M, Aschner J, Shoemaker C. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants. N Engl J Med. 2002;347:643-52 pubmed
    ..There was a small but significant benefit of high-frequency oscillatory ventilation in terms of the pulmonary outcome for very-low-birth-weight infants without an increase in the occurrence of other complications of premature birth. ..
  33. David M, Gervais H, Karmrodt J, Depta A, Kempski O, Markstaller K. Effect of a lung recruitment maneuver by high-frequency oscillatory ventilation in experimental acute lung injury on organ blood flow in pigs. Crit Care. 2006;10:R100 pubmed
    ..Blood flow to the organs was not affected during lung recruitment. These effects were independent of the ventilator mode applied. ..
  34. Bollen C, Uiterwaal C, van Vught A. Systematic review of determinants of mortality in high frequency oscillatory ventilation in acute respiratory distress syndrome. Crit Care. 2006;10:R34 pubmed
    ..PubMed was searched for literature reporting randomized trials and cohort studies of high frequency ventilation in adult patients with acute respiratory distress syndrome...
  35. Sedeek K, Takeuchi M, Suchodolski K, Kacmarek R. Determinants of tidal volume during high-frequency oscillation. Crit Care Med. 2003;31:227-31 pubmed
    ..1 +/- 34.8 mL (4.4 +/- 1.2 mL/kg) was delivered. At low rates and high-pressure amplitudes in this model, tidal volumes approaching conventional mechanical ventilation can be delivered during high-frequency oscillation. ..
  36. Sedeek K, Takeuchi M, Suchodolski K, Vargas S, Shimaoka M, Schnitzer J, et al. Open-lung protective ventilation with pressure control ventilation, high-frequency oscillation, and intratracheal pulmonary ventilation results in similar gas exchange, hemodynamics, and lung mechanics. Anesthesiology. 2003;99:1102-11 pubmed
  37. Migliazza L, Bellan C, Alberti D, Auriemma A, Burgio G, Locatelli G, et al. Retrospective study of 111 cases of congenital diaphragmatic hernia treated with early high-frequency oscillatory ventilation and presurgical stabilization. J Pediatr Surg. 2007;42:1526-32 pubmed
    ..Meanwhile, survival comparisons of low-, intermediate-, and high-risk groups between institutions using different protocols will allow the identification of the best strategy for CDH management. ..
  38. Imai Y, Nakagawa S, Ito Y, Kawano T, Slutsky A, Miyasaka K. Comparison of lung protection strategies using conventional and high-frequency oscillatory ventilation. J Appl Physiol (1985). 2001;91:1836-44 pubmed
    ..Conventional mechanical ventilation using lung protection strategies (low V(T) high PEEP) only attenuated the decrease in oxygenation and pulmonary compliance. Therefore, HFOV may be a preferable option as a lung protection strategy. ..
  39. Rimensberger P. ICU cornerstone: high frequency ventilation is here to stay. Crit Care. 2003;7:342-4 pubmed
  40. Paulsen S, Killyon G, Barillo D. High-frequency percussive ventilation as a salvage modality in adult respiratory distress syndrome: a preliminary study. Am Surg. 2002;68:852-6; discussion 856 pubmed
    ..We advocate further studies of HFPV in non-burn patients with ARDS both as salvage therapy and as replacement for conventional ventilation for the initial treatment for ARDS. ..
  41. Wunsch H, Mapstone J. High-frequency ventilation versus conventional ventilation for the treatment of acute lung injury and acute respiratory distress syndrome: a systematic review and cochrane analysis. Anesth Analg. 2005;100:1765-72 pubmed
    ..Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the Review.). ..
  42. Vento G, Matassa P, Ameglio F, Capoluongo E, Zecca E, Tortorolo L, et al. HFOV in premature neonates: effects on pulmonary mechanics and epithelial lining fluid cytokines. A randomized controlled trial. Intensive Care Med. 2005;31:463-70 pubmed
    ..The objective of this report is to compare the effects of high-frequency oscillatory ventilation (HFOV) versus synchronized intermittent mandatory ventilation (sIMV) from the points of views of biochemical and functional variables...
  43. Stark A. High-frequency oscillatory ventilation to prevent bronchopulmonary dysplasia--are we there yet?. N Engl J Med. 2002;347:682-4 pubmed
  44. Derdak S, Mehta S, Stewart T, Smith T, Rogers M, Buchman T, et al. High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized, controlled trial. Am J Respir Crit Care Med. 2002;166:801-8 pubmed
    ..We conclude that high-frequency oscillation is a safe and effective mode of ventilation for the treatment of acute respiratory distress syndrome in adults. ..
  45. Cartotto R, Cooper A, Esmond J, Gomez M, Fish J, Smith T. Early clinical experience with high-frequency oscillatory ventilation for ARDS in adult burn patients. J Burn Care Rehabil. 2001;22:325-33 pubmed
    ..Importantly, HFOV allowed surgery to proceed in patients who may have otherwise been too unstable to go to the operating room. As far as we are aware, this is the first report of the use of intraoperative HFOV in burn patients. ..
  46. Fliman P, DeRegnier R, Kinsella J, Reynolds M, Rankin L, Steinhorn R. Neonatal extracorporeal life support: impact of new therapies on survival. J Pediatr. 2006;148:595-9 pubmed
    To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO), high frequency ventilation (HFV), and surfactant on mortality among neonates supported with ECLS...
  47. Froese A, Kinsella J. High-frequency oscillatory ventilation: lessons from the neonatal/pediatric experience. Crit Care Med. 2005;33:S115-21 pubmed
    ..In this brief review, we attempt to summarize key physiological principles learned from this cumulative neonatal/pediatric experience with HFOV. ..
  48. Derdak S. High-frequency oscillatory ventilation for adult acute respiratory distress syndrome: a decade of progress. Crit Care Med. 2005;33:S113-4 pubmed
  49. David M, von Bardeleben R, Weiler N, Markstaller K, Scholz A, Karmrodt J, et al. Cardiac function and haemodynamics during transition to high-frequency oscillatory ventilation. Eur J Anaesthesiol. 2004;21:944-52 pubmed
  50. David M, Karmrodt J, Weiler N, Scholz A, Markstaller K, Eberle B. High-frequency oscillatory ventilation in adults with traumatic brain injury and acute respiratory distress syndrome. Acta Anaesthesiol Scand. 2005;49:209-14 pubmed
  51. Brazelton T, Watson K, Murphy M, Al Khadra E, Thompson J, Arnold J. Identification of optimal lung volume during high-frequency oscillatory ventilation using respiratory inductive plethysmography. Crit Care Med. 2001;29:2349-59 pubmed
  52. Froese A. The incremental application of lung-protective high-frequency oscillatory ventilation. Am J Respir Crit Care Med. 2002;166:786-7 pubmed
  53. Lochindarat S, Srisan P, Jatanachai P. Factors effecting the outcome of acute respiratory distress syndrome in pediatric patients treated with high frequency oscillatory ventilation. J Med Assoc Thai. 2003;86 Suppl 3:S618-27 pubmed
    ..These parameters are good indicators for the prognosis of ARDS for patients responding or not responding to HFOV. ..