[The efficacy of external high frequency oscillation: experience in a quadriplegic patient with alveolar...

External high frequency oscillation (EHFO) around a negative pressure using a thoracoabdominal chamber without an artificial airway has been shown to be an effective form of ventilation in a quadriplegic patient. The patient was an 18 year old male, suffering from high-level cervical cord tumor (lipoma). His respiratory distress was severe, respiration was diaphragmatic only. Because of acute respiratory insufficiency, he was intubated and put on IPPV. Attempts at weaning were not thought to be feasible. Then the Hayek Oscillator was applied with a frequency of 120. After 5 days on the Hayek Oscillator, he was extubated. EHFO was associated with a significant increase in PaO2 and VA, and a significant decrease in PaCO2. It is remarkable that the patient expelled sputum whenever he was connected to the Hayek Oscillator, far beyond that achievable by physiotherapy. EHFO avoids the need for endotracheal intubation, thus reducing the hazards of mechanical ventilation attributable to intubation. We conclude that EHFO produces gas exchange significantly and that this technique may have potential clinical application.