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High Frequency Oscillation (HFO): Physiological Basis for a Potentially ‘Optimal’ Protective Ventilatory Strategy

  • A. Rossi
  • T. E. Stewart
  • V. M. Ranieri

Abstract

Acute respiratory distress syndrome (ARDS) is a primary cause of death in ICUs with a reported mortality ranging between 30–60% [1, 2]. Intrapulmonary shunt, increased dead space, and reduced lung compliance are the main pulmonary patho-physiological alterations leading to multiple organ failure (MOF) and ultimately death. Conventional mechanical ventilation is effective in delivering oxygen and providing adequate carbon dioxide clearance, both in volume-cycled and pressure-limited modes. However experimental and clinical data show that conventional ventilation may stress the alveolar wall resulting in further pulmonary injury (ventilator induced lung injury [VILI]) [3, 4]. Tidal volume (VT), positive end-expiratory pressure (PEEP), and inspiratory oxygen fraction (FiO2) are the three key ventilator settings during conventional ventilation. Strong evidence suggests that reducing VT and optimizing PEEP prevents VILI, providing a lung protective strategy [5, 6]. However, ‘conventional’ protective ventilatory strategies are usually accompanied by side effects such as use of high respiratory rate, hypercapnia, hemodynamic impairment, etc. [7].

Keywords

Acute Lung Injury Acute Respiratory Distress Syndrome Dead Space Respir Crit Conventional Mechanical Ventilation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • A. Rossi
  • T. E. Stewart
  • V. M. Ranieri

There are no affiliations available

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