High-frequency ventilation for acute lung injury and ARDS

J. A. Krishnan, R. G. Brower

Research output: Contribution to journalArticle

Abstract

In patients with acute lung injury (ALI) and ARDS, conventional mechanical ventilation (CV) may cause additional lung injury from overdistention of the lung during inspiration, repeated opening and closing of small bronchioles and alveoli, or from excessive stress at the margins between aerated and atelectatic lung regions. Increasing evidence suggests that smaller tidal volumes (VTs) and higher end-expiratory lung volumes (EELVs) may be protective from these forms of ventilator-associated lung injury and may improve outcomes from ALI/ARDS. High-frequency ventilation (HFV)-based ventilatory strategies offer two potential advantages over CV for pateints with ALI/ARDS. First, HFV uses very small VTs, allowing higher EELVs with less overdistention than is possible with CV. Second, despite the small VTs, high respiratory rates during HFV allow the maintenance of normal or near-normal PaCO2 levels. In this review, the use of HFV as a lung protective strategy for patients with ALI/ARDS is discussed.

Original languageEnglish (US)
Pages (from-to)795-807
Number of pages13
JournalCHEST
Volume118
Issue number3
DOIs
StatePublished - Jan 1 2000

Keywords

  • ARDS
  • Acute lung injury
  • Barotrauma
  • High-frequency jet ventilation
  • High-frequency oscillation
  • High-frequency positive-pressure ventilation
  • High-frequency ventilation
  • Mechanical ventilation
  • Volutrauma

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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