USE OF ULTRAHIGH FREQUENCY VENTILATION IN PATIENTS WITH ARDS - A PRELIMINARY-REPORT

Study objective: Our objective was to compare the efficacy of ultrahig h frequency ventilation (UHFV) (frequencies >3 Hz) with respect to oxy genation, airway pressures, and hemodynamic parameters in patients wit h adult respiratory distress syndrome (ARDS) who were not responding t o conventional ventilation. Design: We used a prospective, multicenter , nonrandomized study design in which each patient served as his own c ontrol. Setting: Three university-affiliated, tertiary-care medical ce nters participated. Patients: Persons aged 16 to 79 years old with ARD S and unresponsive to conventional ventilation, as defined by a Food a nd Drug Administration (FDA) approved protocol, were included. Interve ntions: Ninety patients who were not responding to conventional ventil ation were changed to UHFV using a microcomputer-controlled device. Me asurements and results: The patient's blood gas, hemodynamic, and airw ay pressure variables were measured just before, and at 1 and 24 h aft er the switch to UHFV. We demonstrated clinically significant improvem ents in arterial oxygen tension (PaO2) and reductions in peak and mean inspiratory pressures. Conclusions: In a multicenter study, UHFV impr oved respiratory gas exchange and reduced airway pressure variables at both 1 h and 24 h after the onset of UHFV when compared with conventi onal ventilation just prior to the change and without hemodynamic dete rioration, in patients with severe ARDS.