Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children

Graphical simplification of the stepwise incremental–decremental mPaw titration when switching to HFOV. The red line represents the inspiratory limb of the pressure volume loop, whereas the green line represents de deflation limb. The mPaw is increased by 2 cmH2O every 3–5 min until no further improvement in SpO2 and/or decrease in mean ABP occurs during two consecutive increments (identifying mPawrecruitment and mPawhyperinflation). Then, the mPaw is decreased by cmH2O every 3–5 min until SpO2 decreased (mPawderecruitment) during two consecutive decrements. The RM was repeated to mPawhyperinflation with setting the “optimal” mPaw？+？2 cm H2O above mPawderecruitment. mPaw mean airway pressure; SpO2 transcutaneously measured oxygen saturation; mABP mean arterial blood pressur