Rationale for high-frequency oscillation as a primary lung-protective mode in patients with ALI/ARDS

Abstract

Clinicians and researchers are becoming increasingly conscious of the potentially harmful effects of mechanical ventilation, and more attention is being focused on methods of ventilation that may reduce these complications. Indeed the paradigm for mechanical ventilation in patients with acute lung injury (ALI) and acute respi-ratory distress syndrome (ARDS) has evolved in the last 10 years from a goal of nor-malizing blood gases to one of avoiding ventilator-induced lung injury (VILI) while maintaining adequate gas exchange. Lung protection during mechanical ventilation begins with limitation of tidal volume on conventional ventilation, but the optimal method remains to be determined [1]. One potential modality that may be useful in the avoidance of VILI is high-frequency oscillation (HFO). In this chapter, we will introduce HFO, provide a brief discussion of ARDS and VILI, and focus on the preclinical and clinical data available to date supporting the use of HFO as a primary modality to avoid VILI in adults. © 2007 Springer Science + Business Media Inc.