Abstract
High frequency oscillatory ventilation, combined with prone/supine positioning, could be an effective method of treatment in serious forms of extrapulmonary ARDS. Initial continuous distension pressure in peak initial valuesin children can reach a value close to the highest recommended level for adults.
The advantage of HFOV, compared to the conventional ventilation, is the possibility of exact optimal continuous distension pressure titration guided by the oxygenation gain and a better cardiovascular tolerance of the method in extrapulmonary ARDS. The prone and supine position changes and the continuous distension pressure decrease are necessary to be assured according to the oxygenation trend and reactions to the recruitment manoeuvres based on a patient's individual reaction.
Further clinical research is required to study the use of HFOV in the prone and supine positions in severe ARDS in adults and children.