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How does high-frequency oscillatory ventilation (HFOV) work?
Answer
High-Frequency Oscillatory Ventilation (HFOV) operates by delivering very small tidal volumes at high frequencies using a piston-driven diaphragm. This mechanism facilitates active inspiration and expiration, allowing for precise control of the mean airway pressure (MAP).
Active Inspiration and Expiration: The diaphragm moves forward to push air into the patient (inspiration) and backward to suck air out (expiration). This bidirectional movement generates oscillations necessary for ventilation.
Small Tidal Volumes: HFOV delivers tidal volumes of about one to four milliliters per kilogram, which are slightly higher than those provided by HFJV but still very small. This helps reduce the risk of lung injury.
MAP Control: HFOV allows direct setting of the MAP, which is crucial for maintaining consistent lung recruitment and avoiding overdistension. The MAP is controlled through adjustments to the bias flow and the adjust knob, ensuring adequate oxygenation.
By understanding and utilizing these settings, healthcare providers can effectively manage ventilation in critically ill patients, minimizing lung injury and optimizing respiratory support.
Kelly Massa graduated from West Chester University of Pennsylvania in 2008. She started her career at Nemours Children's Health in Wilmington, Delaware, where she joined the CMO and Cardiac OR team and then became the PICU Clinical Lead. In her role as the PICU Lead, she enjoyed providing education not only to RTs but to nurses and physicians as well on mechanical ventilation and other Respiratory topics. Her love of educating and research landed her the current role of Clinical Instructor and Research Coordinator. Since in this role, Kelly has submitted over 30 abstracts to the AARC as well as multiple manuscripts. Kelly also enjoys volunteering her time presenting talks with ICON Academy and at AARC Congress and providing care during medical mission trips to Nigeria.
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'I worked in a level 3 NICU for 16 years and the HFOV was the first choice of ventilation, and we went to the HFJV after there was evidence of PIE'Read Reviews
AARC - CRCE/1.0; CE Broker/1.0 Direct Delivery Of Respiratory Care Services, CE Broker #20-1232038; IACET/0.1
The edge of viability for premature babies has dropped to 22 weeks. This lecture will describe the complexities of ventilating the tiniest lungs and highlight studies that support HFJV.
