Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Crit Care. 2012 Feb;18(1):70-9. doi: 10.1097/MCC.0b013e32834f1805.
High-frequency oscillatory ventilation (HFOV) is increasingly used in adults with the acute respiratory distress syndrome (ARDS), who remain hypoxemic during conventional mechanical ventilation. In this review, we will summarize the trials evaluating HFOV in adults with ARDS and discuss issues relevant to the clinician regarding the use of HFOV.
Several observational and randomized trials support the safety of HFOV and improvements in oxygenation in adult patients with severe ARDS, who remain hypoxemic during conventional mechanical ventilation.
HFOV theoretically meets the goals of lung-protective ventilation. On the basis of the current evidence, HFOV is associated with improvements in oxygenation in severe, adult ARDS. However, whether HFOV influences mortality, length of ICU stay, ventilator-free days, quality-of-life factors and is cost-effective remains to be determined. Large, prospective, randomized controlled trials such as the ongoing OSCAR and OSCILLATE trials will help further define the role of HFOV in adult ARDS.
高频振荡通气（HFOV）越来越多地用于急性呼吸窘迫综合征（ARDS）成人患者，这些患者在常规机械通气期间仍存在低氧血症。在这篇综述中，我们将总结评估 ARDS 成人患者中 HFOV 的试验，并讨论与临床医生使用 HFOV 相关的问题。
几项观察性和随机试验支持 HFOV 的安全性，并改善了在常规机械通气期间仍存在低氧血症的严重 ARDS 成人患者的氧合。
HFOV 从理论上满足了肺保护性通气的目标。基于目前的证据，HFOV 与严重成人 ARDS 患者的氧合改善相关。然而，HFOV 是否影响死亡率、ICU 住院时间、无呼吸机天数、生活质量因素以及是否具有成本效益仍有待确定。大型前瞻性随机对照试验，如正在进行的 OSCAR 和 OSCILLATE 试验，将有助于进一步确定 HFOV 在成人 ARDS 中的作用。
