High-frequency oscillatory ventilation can be effective as rescue therapy for refractory acute lung dysfunction

High-frequency oscillatory ventilation (HFOV) is a technique with limited u se in adult patients. The main purpose of this pilot study was to evaluate HFOV on adult trauma patients with refractory lung dysfunction. Refractory lung dysfunction was defined as a PaO2:FiO(2) ratio <75 for 1 hour despite maximum support via conventional mechanical ventilation (CMV). Five patient s were placed on HFOV after failing CMV between May 1998 and December 1998. The mean PaO2:FiO(2) ratio at the time of initiation (52.2 +/- 4.73) of HF OV increased significantly (P < 0.05) by 2 hours (126.8 +21) and was still significantly increased (P < 0.01) after 48 hours (181 +26.1) on HFOV. The mean airway pressures (MAPs) and peak pressures were significantly lower (P < 0.01) after HFOV. The average MAP of the five patients was 34.6 +1.6 cm H2O at time zero and 25.2 cm H2O after 48 hours of HFOV. The mean peak pres sure was 52.4 +3.0 cm H2O at time zero and was 35.8 +/- 3.01 after terminat ion of HFOV. Survival was 80.0 per cent (four of five patients). In conclus ion, all patients improved after initiation of HFOV, and HFOV should be con sidered in the treatment of patients with acute refractory lung dysfunction .