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High Frequency Oscillation (HFO): Physiological Basis for a Potentially ‘Optimal’ Protective Ventilatory Strategy

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Intensive Care Medicine

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Abstract

Acute respiratory distress syndrome (ARDS) is a primary cause of death in ICUs with a reported mortality ranging between 30–60% [1, 2]. Intrapulmonary shunt, increased dead space, and reduced lung compliance are the main pulmonary patho-physiological alterations leading to multiple organ failure (MOF) and ultimately death. Conventional mechanical ventilation is effective in delivering oxygen and providing adequate carbon dioxide clearance, both in volume-cycled and pressure-limited modes. However experimental and clinical data show that conventional ventilation may stress the alveolar wall resulting in further pulmonary injury (ventilator induced lung injury [VILI]) [3, 4]. Tidal volume (VT), positive end-expiratory pressure (PEEP), and inspiratory oxygen fraction (FiO2) are the three key ventilator settings during conventional ventilation. Strong evidence suggests that reducing VT and optimizing PEEP prevents VILI, providing a lung protective strategy [5, 6]. However, ‘conventional’ protective ventilatory strategies are usually accompanied by side effects such as use of high respiratory rate, hypercapnia, hemodynamic impairment, etc. [7].

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Authors
  1. A. Rossi
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  2. T. E. Stewart
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  3. V. M. Ranieri
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

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© 2003 Springer-Verlag Berlin Heidelberg

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Rossi, A., Stewart, T.E., Ranieri, V.M. (2003). High Frequency Oscillation (HFO): Physiological Basis for a Potentially ‘Optimal’ Protective Ventilatory Strategy. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5548-0_28

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  • DOI: https://doi.org/10.1007/978-1-4757-5548-0_28

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-5550-3

  • Online ISBN: 978-1-4757-5548-0

  • eBook Packages: Springer Book Archive

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