High-frequency ventilation for acute traumatic and nontraumatic lung injury

Introduction

ARDS is commonly observed in trauma patients. In some instances the severity of the clinical presentation is such that all conventional ventilatory support mode fails. In this setting, high-frequency oscillatory ventilation (HFOV) was considered mostly a rescue therapy.

Methods

Fifteen adult patients admitted to our ICU for acute traumatic and nontraumatic lung injury were submitted to HFOV when conventional mechanical ventilation failed.

Results

Clinical and demographic data are shown in Table 1. Figure 1 shows the trend of gas parameters during the recovery. At baseline PaO₂ was 94 ± 28 mmHg; after 6 hours of HFOV: 135 ± 41 mmHg, P < 0.01. At baseline PaO₂/FiO₂ was 182 ± 97 mmHg; after 6 hours of HFOV: 264 ± 101 mmHg, P < 0.01. The benefits are maintained when returned to conventional ventilation.

Table 1 Clinical and demographic data

Figure 1

Mean PaO ₂ , PaCO ₂ , PaO ₂ /FiO ₂ at baseline and during HFOV (P, percussionator; C, conventional). *P <0.05 versus baseline, ^† P <0.01 versus baseline.

Conclusion

HFOV may therefore be anticipated to improve end-organ perfusion and gas exchange; it should be considered in severe traumatic and nontraumatic respiratory failure [1].