High-frequency oscillatory ventilation: A narrative review.

Area of Science:

• Critical Care Medicine
• Respiratory Physiology
• Mechanical Ventilation

Background:

• High-frequency oscillatory ventilation (HFOV) is a lung-protective mechanical ventilation strategy.
• It is often employed as a rescue therapy for patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) when conventional ventilation (CV) proves insufficient.

Purpose of the Study:

• To provide a comprehensive review of HFOV.
• To discuss its indications, contraindications, hazards, and monitoring parameters.
• To compare HFOV with other mechanical ventilation modes.

Main Methods:

• This narrative review synthesizes existing literature on HFOV.
• It examines clinical applications, mechanisms of action, and patient selection criteria.

Main Results:

• HFOV utilizes low tidal volumes and high respiratory rates with constant mean airway pressures.
• This approach aims to mitigate ventilator-induced lung injury (VILI) by avoiding the 'inflate-deflate' cycle of CV.
• While statistical evidence is limited, HFOV shows potential benefits in oxygenation and ventilation.

Conclusions:

• HFOV is a safe and effective rescue ventilation mode for ARDS and VILI.
• Patients at risk of or experiencing VILI or ARDS, particularly those failing CV, are suitable candidates for HFOV.