Smith-HFOV adult ARDS July 2007

Smith-HFOV adult ARDS July 2007 - High-frequency...

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High-frequency oscillatory ventilation in adults Geoff Smith SICU July 2007
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Trauma with Acute Respiratory Distress Syndrome JS: 19yo man drove car off embankment into water while intoxicated. Ambulatory at scene with GCS15. Presenting pH 6.9. Oxygen saturation dropped and respiratory distress ensued, prompting emergent intubation in the ED.
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High-Frequency Oscillatory Ventilation (HFOV) “Lung protective” ventilation that oscillates the lung around a constant mean airway pressure higher than conventional ventilation Significant pressure swings in the endotracheal tube, but pressure fluctuations are attenuated at the alveoli First established for use in pediatrics cases of neonatal ARDS No mortality benefit yet demonstrated in children (multiple RCTs) or adults (Multicenter Oscillatory Ventilation for ARDS Trial [MOAT] 2002, Bollen et al. 2005)
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Smaller VT Limit alveolar overdistension Higher mean airway pressure (mPaw/Pmaw) More alveolar recruitment
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  • Fall '11
  • Dr.Aslam
  • Acute respiratory distress syndrome, RCT, Moat, HFOV, bilateral pulmonary infiltrates, Multicenter Oscillatory Ventilation

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Smith-HFOV adult ARDS July 2007 - High-frequency...

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