High-frequency oscillatory ventilation — a clinical approach

Since its inception over a decade ago, HFOV has become an increasingly utilised and effective strategy for the treatment of acute lung injury and acute respiratory distress syndrome. During HFOV, the lungs are recruited and stabilised to avoid the cyclic stretch and shear exerted on the alveoli which occur during conventional ventilation by repeated alveolar collapse and re-expansion. Patients with deteriorating gas exchange despite increasing ventilatory settings can be successfully managed with HFOV as it provides significant lung protection. However, as with any mode of ventilation, management strategies must be designed to minimise (or eliminate) ventilator-induced lung injury based on a patient's pathophysiology. SAJCC Vol. 21 (1) 2005: pp. 15-24