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Critical Care
Published in: Critical Care 4/2006

01-08-2006 | Commentary

Ventilatory management of ARDS: high frequency oscillation and lung recruitment!

Author: Robert M Kacmarek

Published in: Critical Care | Issue 4/2006

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Abstract

Many aspects of ventilatory management in patients with ARDS are still controversial and one of the major controversies is should HFO or CMV ideally be used to manage this patients. As shown by David et al. when the two approaches to ventilatory support are applied using similar principles the physiologic outcomes appear to be similar. With both approaches the use of lung recruitment maneuvers early in ARDS (1 to 3 day) after hemodynamic stabilization in patients without baratrauma is promising. The key to managing ARDS regardless of mode is to use an open lung protective ventilatory strategy. It is not the mode that makes the difference, it is the approach used to apply the mode!
Literature
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Dreyfuss D, Saumon G: Ventilator induced lung injury: Lessons from experimental studies. Am J Respir Crit Care Med 1998, 157: 294-323.CrossRefPubMed
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David M, Gervais HW, Karmrodt J, Depta AL, Kempski O, Mark-staller K: Effect of a lung recruitment maneuver by high-frequency oscillatory ventilation in experimental acute lung injury on organ blood flow in pigs. Crit Care 2006, 10: R100. 10.1186/cc4967PubMedCentralCrossRefPubMed
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Sedeek K, Takeuchi M, Suchodolski K, Vargas S, Shimaoka M, Schnitzer J, Kacmarek RM: Open-lung protective ventilation with pressure control ventilation, high-frequency oscillation, and intratracheal pulmonary ventilation results in similar gas exchange, hemodynamics, and lung mechanics. Anesthesiology 2003, 99: 1102-1111. 10.1097/00000542-200311000-00016CrossRefPubMed
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Borges JB, Okamoto VN, Gustavo M, Caramez MPR, Arantes PR, Barros F, Souza CE, Victorino JA, Kacmarek RM, Barbas CSV, et al.: Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome. Am J Respir Crit Care Med 2006, 174: 268-278. 10.1164/rccm.200506-976OCCrossRefPubMed
Metadata
Title
Ventilatory management of ARDS: high frequency oscillation and lung recruitment!
Author
Robert M Kacmarek
Publication date
01-08-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5018

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