A successful application of high-frequency oscillation ventilation in extremely severe forms of ARDS in children
Abstract
During the prospective observational clinical study of HFOV in adult ARDS (n=30), two children (13 months a 17 years of age) suffering from severe ARDS (oxygenation index OI=75 and 50, respectively) underwent the same therapeutical protocol. In the both cases the higher initial effective continuous distension pressure (CDP=4.0 and 4.5 kPa) was used compared with the highest CDP valuess in adult group.
HFOV with such high CDP values led to improvement of oxygenation and circulatory parameters contrary to CMV period. Acceptable oxygenation parameters with the use of fraction of inspired oxygen fraction F1O2=0.4 were achieved within 24 hours period, in one case also in combination with prone/supine positioning.
The authors recommend to focus next clinical trials to combined HFOV/pronesupine therapeutical approach.