A registry of high-frequency oscillatory ventilation in adults

Introduction

High-frequency oscillatory ventilation (HFOV) theoretically provides the ideal mode of ventilation for patients with acute lung injury. By avoiding repeated recruitment and de-recruitment of lung units it has the potential to reduce ventilator-associated lung injury. In the vast majority of centres, however, it is still only used as rescue therapy for patients failing conventional ventilation (CV). In our 29-bed university hospital ITU we maintain a registry of patients receiving HFOV, and the first 25 entries are presented here.

Patients

Patient demographics are presented in Table 1. Changes in gas exchange are presented in Table 2. Complications attributable to HFOV were CVS instability (4/25); pneumothorax (3/25) and ETT blockage (2/25). Two out of 25 patients died on HFOV; 5/25 died on CV post-HFOV and 18/25 were discharged alive from the ICU.

Table 1

Table 2

Conclusion

HFOV is currently perceived as a rescue therapy in adult patients unresponsive to CV. Our experience of using HFOV in acute lung injury shows that it is an effective method of ventilation in refractory respiratory failure and is also a safe and practical alternative to CV when used early in acute lung injury.