High Frequency Oscillatory Ventilation in Adults with ARDS: Past, Present, and Future.
Chest(2017)
摘要
High-frequency oscillatory ventilation (HFOV) is a unique mode of mechanical ventilation that utilizes non-conventional gas exchange mechanisms to deliver ventilation at very low tidal volumes and high frequencies. The properties of HFOV make it a potentially ideal mode to prevent ventilator-induced lung injury in patients with acute respiratory distress syndrome. Despite a compelling physiological basis and promising experimental data, large randomized controlled trials have not detected an improvement in survival with the use of HFOV; the use of HFOV as an early lung-protective strategy in patients with ARDS may be harmful. Nevertheless, HFOV still has an important potential role in the management of refractory hypoxemia. Careful attention should be paid to right ventricular function and lung stress when applying HFOV. This review discusses the physiological principles, clinical evidence, practical applications, and future prospects for the use of HFOV in patients with ARDS.
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关键词
ARDS,mechanical ventilation,respiratory failure
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