High-frequency oscillatory ventilation and ventilator-induced lung injury

Abstract

Although mechanical ventilation is lifesaving for patients with acute respiratory distress syndrome, it can cause ventilator-induced lung injury. To minimize ventilator-induced lung injury, different ventilatory strategies have been developed. One of the strategies is the use of high-frequency oscillatory ventilation (HFOV). Because of the novel gas exchange mechanisms, HFOV can provide adequate gas exchange using extremely small tidal volumes and maintain high end-expiratory lung volume without inducing overdistension, which should result in minimization of ventilator-induced lung injury. There are convincing clinical and animal data indicating that HFOV is an ideal lung-protective ventilatory strategy, particularly in the setting of neonatal respi-ratory failure, if lung volume recruitment is performed. A recent clinical trial demonstrated early (p