RT Journal Article
SR Electronic
T1 Evaluation of High-Frequency Oscillatory Ventilation as a Rescue Strategy in Respiratory Failure
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.08936
DO 10.4187/respcare.08936
A1 Guramrinder Singh Thind
A1 Umur Hatipoğlu
A1 Robert L Chatburn
A1 Sudhir Krishnan
A1 Abhijit Duggal
A1 Eduardo Mireles-Cabodevila
YR 2021
UL http://rc.rcjournal.com/content/early/2021/08/24/respcare.08936.abstract
AB BACKGROUND: The use of high-frequency oscillatory ventilation (HFOV) is backed by sound physiologic rationale, but clinical data on the elective use of HFOV have been largely disappointing. Nonetheless, HFOV is still occasionally used as a rescue mode in patients with severe hypoxemia. The evidence that supports this practice is sparse.METHODS: This was a retrospective single-center analysis that involved subjects admitted to the medical ICU at Cleveland Clinic, Cleveland, Ohio. We included all adult patients (ages > 18 y) who received rescue HFOV between January 1, 2010, and December 31, 2018, and analyzed their clinical outcomes.RESULTS: A total of 48 subjects were included in the analysis. The most common primary diagnosis was pneumonia (n = 33 [68.8%]), followed by aspiration (n = 6 [12.5%]) and diffuse alveolar hemorrhage (n = 2 [4.2%]). Switching to HFOV improved oxygenation but also increased vasopressor requirements at 3 h. The mortality rate of the study population was 92% (44/48).CONCLUSIONS: Our study did not support utilization of HFOV as a “last-ditch” rescue measure in subjects with respiratory failure. The delayed timing of HFOV initiation and its detrimental hemodynamic effects are among the potential reasons for the high mortality rate.