High frequency oscillatory ventilation is characterized by very low tidal volumes, often smaller than anatomic death space, and high respiratory frequencies (3-15 Hz). This strategy was thought to reduce ventilator induced lung injury, avoiding volutrauma and barotrauma. According to most recent data, high frequency oscillatory ventilation does not offer any real advantage when compared to current protective lung ventilation. Moreover it is associated with an increased need for sedative and neuromuscular blocker drugs, unstable hemodynamics and lung barotrauma. The OSCILLATE trial demonstrated an increased risk of death in patients undergoing high frequency oscillatory ventilation. Therefore, high frequency oscillatory ventilation should be avoided as a first-line treatment in patients with acute respiratory distress syndrome.
- Acute respiratory distress syndrome
- Critically ill
- High-frequency oscillatory ventilation
- Mechanical ventilation
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