@article {Thind1746, author = {Guramrinder Singh Thind and Umur Hatipo{\u g}lu and Robert L Chatburn and Sudhir Krishnan and Abhijit Duggal and Eduardo Mireles-Cabodevila}, title = {Evaluation of High-Frequency Oscillatory Ventilation as a Rescue Strategy in Respiratory Failure}, volume = {66}, number = {11}, pages = {1746--1751}, year = {2021}, doi = {10.4187/respcare.08936}, publisher = {Respiratory Care}, abstract = {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 {\textquotedblleft}last-ditch{\textquotedblright} 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.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/66/11/1746}, eprint = {https://rc.rcjournal.com/content/66/11/1746.full.pdf}, journal = {Respiratory Care} }