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High frequency oscillatory ventilation in children. What do we know so far?

F Diaz1, Y Kalra, N M Tofil

  • 1Critical Care Division, Department of Pediatrics, University of Alabama at Birmingham Birmingham, AL, USA - francodiazr@gmail.com.

Minerva Pediatrica
|February 7, 2015
PubMed

Insights

High frequency oscillatory ventilation (HFOV) offers potential benefits for pediatric respiratory failure, aiming to improve gas exchange and limit lung injury. This review explores HFOV principles and its application in critical pediatric respiratory conditions.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Mechanical Ventilation

Background:

  • Pediatric respiratory failure is a common reason for ICU admission globally.
  • Acute respiratory distress syndrome (ARDS) is the most severe form, with high mortality (33%).
  • Current ventilator strategies for heterogeneous ARDS have limitations.

Purpose of the Study:

  • To review the principles and physiology of High Frequency Oscillatory Ventilation (HFOV).
  • To discuss the role of HFOV in managing pediatric respiratory failure.
  • To highlight HFOV strategies like "open lung" and "low volume" ventilation.

Main Methods:

  • Review of existing literature on HFOV in pediatric respiratory failure.
  • Discussion of physiological principles underlying HFOV.
  • Analysis of HFOV application in specific pediatric conditions.

Main Results:

  • HFOV is an alternative mechanical ventilation strategy with potential to improve gas exchange.
  • HFOV may help limit ventilator-induced lung injury.
  • Specific strategies like "open lung" and "low volume" ventilation are discussed for different pediatric respiratory failure scenarios.

Conclusions:

  • HFOV presents an alternative approach for pediatric respiratory failure management.
  • The "open lung" strategy is emphasized for conditions reducing functional residual capacity.
  • The "low volume" strategy is relevant for airleak syndromes like pneumothorax.

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