High-frequency percussive ventilation (HFPV) is a pneumatically powered, time-cycled pressure mode of ventilation. HFPV is considered an advanced mode of ventilation delivered by the Volumetric Diffusive Respirator (VDR-4, Percussionaire, Sandpoint, Idaho), which combines the principles of high-frequency ventilation with those of conventional mechanical ventilation. The VDR-4 uses a Phasitron to deliver percussive breaths to propel secretions to the mainstem airways. HFPV has shown success in treating adults and neonatal and pediatric patients with ventilation and oxygenation failure.1–4
The study in this issue of Respiratory Care by White et al5 adds to the HFPV literature by evaluating how HFPV affects gas exchange in subjects with acute bronchiolitis and who are intubated. More specifically, these investigators hypothesized that HFPV would improve both oxygenation and ventilation without negative hemodynamic effects or complications. In this single-center, prospective study, they transitioned 35 subjects with the primary diagnosis of bronchiolitis to HFPV.5 The subjects were placed on HFPV for 1 of 4 indications: (1) ventilation failure (n = 21), (2) mixed oxygenation and ventilation failure (n = 5), (3) secretion management (n = 5), and (4) oxygenation failure (n = 4).5 The management of HFPV, sedation, and …
Correspondence: Cheryl Dominick, Pediatric Intensive Care Unit, Department of Respiratory Care, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd., 7NW149, Philadelphia, PA 19104. E-mail: defalco{at}chop.edu
