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High-Frequency Oscillatory Ventilation in the Neonate

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Pediatric and Neonatal Mechanical Ventilation

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Abstract

The classical approach was to consider to switch the patient to HFOV when conventional modes of ventilation fail to provide adequate oxygenation or adequate alveolar ventilation (i.e. rescue HFOV) in infants with respiratory distress syndrome given the more recent understanding that “non-lung-protective” mechanical ventilation, large tidal volume ventilation and/or high peak pressure ventilation or probably more high peak to PEEP pressure swings can cause or worsen lung injury in the experimental setting within a short time period Therefore, to initiate in (prematurely born) newborns HFOV early (i.e. from birth and/or immediately after intubation) as a lung-protective ventilator sounds reasonable The second concept to be applied is to search for adequate lung recruitment. In addition choosing oscillation frequency and amplitude optimal according respiratory system mechanics seems to be of importance. Part of these concepts of optimizing HFOV settings at bedside do also apply to the use of HFOV in bigger children. In this chapter we try to give some “recipes” for optimizing the use of HFOV in various clinical conditions and age categories.

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Authors and Affiliations

  1. Division of Critical Care Medicine, Department of Anesthesia, Anesthesia and Critical Care, Respiratory Care/ECMO/Biomedical Engineering, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    John H. Arnold MD

  2. Department of Pediatrics, Service of Neonatology and Pediatric Intensive Care, University Hospital of Geneva, CH-1211, Geneva 14, Switzerland

    Peter C. Rimensberger

  3. Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Gerhard K. Wolf MD

Authors
  1. John H. Arnold MD
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  2. Peter C. Rimensberger
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  3. Gerhard K. Wolf MD
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Corresponding authors

Correspondence to Peter C. Rimensberger or Gerhard K. Wolf MD .

Editor information

Editors and Affiliations

  1. Service of Neonatology and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneve, Switzerland

    Peter C. Rimensberger

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Arnold, J.H., Rimensberger, P.C., Wolf, G.K. (2015). High-Frequency Oscillatory Ventilation in the Neonate. In: Rimensberger, P. (eds) Pediatric and Neonatal Mechanical Ventilation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01219-8_45

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  • DOI: https://doi.org/10.1007/978-3-642-01219-8_45

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-01218-1

  • Online ISBN: 978-3-642-01219-8

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