High-frequency percussive ventilation in severe acute respiratory distress syndrome: A single center experience

• Published in: Journal of anaesthesiology, clinical pharmacology clinical pharmacology, 2014-01, Vol.30 (1), p.65-70
• Main Authors: Spapen, Herbert, Borremans, Marianne, Diltoer, Marc, Gorp, Viola, Nguyen, Duc, Honoré, Patrick
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Care and treatment; Case studies; Continuous positive airway pressure; high-frequency percussive ventilation; Original; pneumonia; Severe acute respiratory syndrome
• ISSN: 0970-9185; 2231-2730
• DOI: 10.4103/0970-9185.125706

Background: Few studies have investigated high-frequency percussive ventilation (HFPV) in adult patients with acute respiratory distress syndrome (ARDS). Materials and Methods: We retrospectively analyzed data from critically ill-patients with moderate and severe ARDS who received HFPV. Ventilation and oxygenation were governed according to a predefined protocol. HFPV was continued until patients could be switched to conventional ventilation. Results: A total of 42 patients (20 with pneumonia-related ARDS and 22 non-septic ARDS cases) were evaluable. Baseline demographic characteristics, severity of illness, lung injury score; pH and respiratory variables were comparable between pneumonia and non-sepsis-related ARDS. Within 24 h, HFPV restored normal pH and PaCO 2 and considerably improved oxygenation. Oxygenation improved more in non-septic than in pneumonia-related ARDS. Patients with pneumonia-induced ARDS also remained longer HFPV-dependent (7.0 vs. 4.9 days; P < 0.05). Mortality at 30 days was significantly higher in pneumonia-related than in non-sepsis-related ARDS (50% vs. 18%; P = 0.01). Conclusions: HFPV caused rapid and sustained improvement of oxygenation and ventilation in patients with moderate to severe ARDS. Less improved oxygenation, longer ventilator dependency and worse survival were observed in pneumonia-related ARDS.