High frequency oscillation ventilation - Revision history

Mholtz: Text replacement - "->" to "→"

2017-02-09T03:01:54Z

Text replacement - "->" to "→"

← Older revision		Revision as of 03:01, 9 February 2017
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	*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds		*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds
	*I:E time of 1:2		*I:E time of 1:2
	*Initiate high frequency ventilation -> 3-15 Hz		*Initiate high frequency ventilation → 3-15 Hz
	*VT minimized to keep pH >7.25		*VT minimized to keep pH >7.25
	**Goal of 1-4 ml/Kg		**Goal of 1-4 ml/Kg

Neil.m.young: Text replacement - "* " to "*"

2016-07-04T12:09:20Z

Text replacement - "* " to "*"

← Older revision		Revision as of 12:09, 4 July 2016
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	*Studied in patients with PaO2/FiO2 < 200		*Studied in patients with PaO2/FiO2 < 200
	*Goal is to maintain alveolar recruitment for adequate gas exchange and decrease lung injury/atelectrauma		*Goal is to maintain alveolar recruitment for adequate gas exchange and decrease lung injury/atelectrauma
	** Low tidal volumes based around mean airway pressures to keep alveoli open		**Low tidal volumes based around mean airway pressures to keep alveoli open
	** Delivered at high frequency		**Delivered at high frequency

	===Pros===		===Pros===
	* Limits VILI		*Limits VILI
	* May improve oxygenation when ECMO not available		*May improve oxygenation when ECMO not available

	===Cons===		===Cons===
	* No difference or likely to cause harm in adult ARDS patients		*No difference or likely to cause harm in adult ARDS patients
	* Requires heavy sedation		*Requires heavy sedation
	* Increase mean airway pressures may result in more hemodynamic instability		*Increase mean airway pressures may result in more hemodynamic instability

	==Procedure==		==Procedure==
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	'''Oxygenation''' altered by:		'''Oxygenation''' altered by:
	* FiO2		*FiO2
	* Mean airway pressures		*Mean airway pressures

	'''Ventilation''' altered by:		'''Ventilation''' altered by:
	* Frequency		*Frequency
	**Decrease frequency to increase TV and ventilation		**Decrease frequency to increase TV and ventilation
	* Inspiratory time		*Inspiratory time
	* Amplitude of oscillations		*Amplitude of oscillations

	==See Also==		==See Also==

Rossdonaldson1: /* ConsOscillate trial */

2016-06-28T18:11:22Z

ConsOscillate trial

← Older revision		Revision as of 18:11, 28 June 2016
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	* May improve oxygenation when ECMO not available		* May improve oxygenation when ECMO not available

	===Cons~~<ref>[https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial</ref>~~===		===Cons===
	* No difference or likely to cause harm in adult ARDS patients		* No difference or likely to cause harm in adult ARDS patients
	* Requires heavy sedation		* Requires heavy sedation

Rossdonaldson1: /* Background */

2016-06-28T18:10:43Z

Background

← Older revision		Revision as of 18:10, 28 June 2016
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	* May improve oxygenation when ECMO not available		* May improve oxygenation when ECMO not available

	===Cons===		===Cons<ref>[https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial</ref>===
	* No difference or likely to cause harm in adult ARDS patients		* No difference or likely to cause harm in adult ARDS patients
	* Requires heavy sedation		* Requires heavy sedation
	* Increase mean airway pressures may result in more hemodynamic instability		* Increase mean airway pressures may result in more hemodynamic instability

	* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial

	==Procedure==		==Procedure==

Rossdonaldson1: /* Background */

2016-06-28T18:10:12Z

Background

← Older revision		Revision as of 18:10, 28 June 2016
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	** Delivered at high frequency		** Delivered at high frequency

	* Pros		===Pros===
	** Limits VILI		* Limits VILI
	** May improve oxygenation when ECMO not available		* May improve oxygenation when ECMO not available

	* Cons		===Cons===
	** No difference or likely to cause harm in adult ARDS patients		* No difference or likely to cause harm in adult ARDS patients
	** Requires heavy sedation		* Requires heavy sedation
	** Increase mean airway pressures may result in more hemodynamic instability		* Increase mean airway pressures may result in more hemodynamic instability

	* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial		* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial

Neil.m.young at 15:35, 26 June 2016

2016-06-26T15:35:28Z

← Older revision		Revision as of 15:35, 26 June 2016
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	===Background===		==Background==
	*High Frequency Oscillation Ventilation (HFOV) is an alternative method for mechanical ventilation in difficult to oxygenate in critically ill [[ARDS]] patients.		*High Frequency Oscillation Ventilation (HFOV) is an alternative method for mechanical ventilation in difficult to oxygenate in critically ill [[ARDS]] patients.
	*Studied in patients with PaO2/FiO2 < 200		*Studied in patients with PaO2/FiO2 < 200
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	* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial		* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial

	===Procedure===		==Procedure==
	''Example protocol from Oscillate trial<ref>Fergusson N, Cook D, Guyatt G. High-frequency Oscillation in Early Acute Respiratory Distress Syndrome. NEJM 2013; 368:795-805</ref>''		''Example protocol from Oscillate trial<ref>Fergusson N, Cook D, Guyatt G. High-frequency Oscillation in Early Acute Respiratory Distress Syndrome. NEJM 2013; 368:795-805</ref>''
	*Set FiO2 at 100%		*Set FiO2 at 100%
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	* Amplitude of oscillations		* Amplitude of oscillations

	===See Also===		==See Also==
	~~[http://lifeinthefastlane.com/ccc/high-frequency-oscillation-~~ventilation~~-hfov/ Life in the Fast Lane] - for an excellent review and tutorial<br />~~		{{Mechanical ventilation pages}}

	[http://www.nejm.org/doi/full/10.1056/NEJMoa1215554#t=article Oscillate]~~<br~~ />		==External Links==
			*[http://lifeinthefastlane.com/ccc/high-frequency-oscillation-ventilation-hfov/ Life in the Fast Lane] - for an excellent review and tutorial
			*[http://www.nejm.org/doi/full/10.1056/NEJMoa1215554#t=article Oscillate]
			*[http://www.nejm.org/doi/full/10.1056/NEJMoa1215716#t=article OSCAR]

	[~~http~~:~~//www.nejm.org/doi/full/10.1056/NEJMoa1215716#t=article OSCAR~~]		==References==
			<references/>

			[[Category:Pulmonary]][[Category:Critical Care]]

Perobinson: /* See Also */

2016-06-22T19:18:55Z

Perobinson: /* Procedure */

2016-06-22T19:18:37Z

Procedure

← Older revision		Revision as of 19:18, 22 June 2016
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	'''Ventilation''' altered by:		'''Ventilation''' altered by:
	* Frequency		* Frequency
			**Decrease frequency to increase TV and ventilation
	* Inspiratory time		* Inspiratory time
	* Amplitude of oscillations		* Amplitude of oscillations

Perobinson: /* Procedure */

2016-06-22T19:17:32Z

Procedure

← Older revision		Revision as of 19:17, 22 June 2016
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	===Procedure===		===Procedure===
	''<ref>Fergusson N, Cook D, Guyatt G. High-frequency Oscillation in Early Acute Respiratory Distress Syndrome. NEJM 2013; 368:795-805</ref>''		''Example protocol from Oscillate trial<ref>Fergusson N, Cook D, Guyatt G. High-frequency Oscillation in Early Acute Respiratory Distress Syndrome. NEJM 2013; 368:795-805</ref>''
	*Set FiO2 at 100%		*Set FiO2 at 100%
	*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds		*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds

Perobinson at 19:16, 22 June 2016

2016-06-22T19:16:47Z

← Older revision		Revision as of 19:16, 22 June 2016
Line 18:		Line 18:

	===Procedure===		===Procedure===
	''~~Ventilator protocol from the Oscillate trial~~''		''<ref>Fergusson N, Cook D, Guyatt G. High-frequency Oscillation in Early Acute Respiratory Distress Syndrome. NEJM 2013; 368:795-805</ref>''
	*Set FiO2 at 100%		*Set FiO2 at 100%
	*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds		*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds
Line 41:		Line 41:
	* Inspiratory time		* Inspiratory time
	* Amplitude of oscillations		* Amplitude of oscillations

			===See Also===
			[http://lifeinthefastlane.com/ccc/high-frequency-oscillation-ventilation-hfov/ Life in the Fast Lane] - for an excellent review and tutorial
			[http://www.nejm.org/doi/full/10.1056/NEJMoa1215554#t=article Oscillate]
			[http://www.nejm.org/doi/full/10.1056/NEJMoa1215716#t=article OSCAR]

← Older revision		Revision as of 19:18, 22 June 2016
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	===See Also===		===See Also===
	[http://lifeinthefastlane.com/ccc/high-frequency-oscillation-ventilation-hfov/ Life in the Fast Lane] - for an excellent review and tutorial		[http://lifeinthefastlane.com/ccc/high-frequency-oscillation-ventilation-hfov/ Life in the Fast Lane] - for an excellent review and tutorial<br />
	[http://www.nejm.org/doi/full/10.1056/NEJMoa1215554#t=article Oscillate]
			[http://www.nejm.org/doi/full/10.1056/NEJMoa1215554#t=article Oscillate]<br />

	[http://www.nejm.org/doi/full/10.1056/NEJMoa1215716#t=article OSCAR]		[http://www.nejm.org/doi/full/10.1056/NEJMoa1215716#t=article OSCAR]