High frequency oscillatory ventilation
HVOF can be used in ARDS, but is used as a rescue therapy when when conventional mechanical ventilation (CV) has failed. It prevents ventilator-induced lung injury (VILI) by reducing the risk of volutrauma, while providing adequate ventilation. It works through entire cycle operates in the “safe window” to achieve homogeneous aeration of the lung and avoid overdistension or atelectasis.
The preferred mode of ventilation is conventional ventilation with the lowest possible plateau pressure and tidal volume.
HFOV is less effective in disease processes with increased airway resistance, which can lead to air trapping and hyperinflation and cause barotrauma. During suctioning, patients on HVOF can also experience alveolar derecruitment. The patient requires constant monitoring.