High-Frequency Percussive Ventilation (HFPV or VDR) with Dr. John Lin (2/2)
PedsCrit
What percussive frequency ranges are typical and risky?
John Lin gives typical ranges (400–700), age adjustments, and warns low frequencies risk air leak from larger percussive volumes.
Learning Objectives:
By the end of this two-part series, listeners should be able to discuss:
- The physiologic rationale supporting the use of high-frequency percussive ventilation (Volumetric Diffusive Respiration, or HFPV).
- Patient populations most likely to benefit from HFPV.
- Key published evidence that informs our use of HFPV in pediatric critical care.
- An expert approach to managing a patient with HFPV.
- Next steps in research that will direct our understanding of the use of HFPV in pediatric critical care.
About our Guest:
Dr. John Lin is a Professor of Pediatrics at Washington University in St. Louis. He serves as the Critical Care Fellowship Program Director and Medical Director of Respiratory Care at St. Louis Children’s Hospital. His academic interests are aimed at the implementation of specific task-based processes and systems-based interventions that increase team performance.
References:
- Butler AD, Dominick CL, Yehya N. High frequency percussive ventilation in pediatric acute respiratory failure. Pediatr Pulmonol. 2021 Feb;56(2):502-508. doi: 10.1002/ppul.25191. Epub 2020 Dec 8. PMID: 33258557; PMCID: PMC7902396.
- Linda Melchor. (2021, July 22). High-Frequency Percussive Ventilation – Using the VDR, or HFPV-4. Criticalcarenow.Com.
- Salim, A., & Martin, M. (2005). High-frequency percussive ventilation. Critical Care Medicine, 33(Supplement), S241–S245. https://doi.org/10.1097/01.CCM.0000155921.32083.CE
- Dominick, C., Nickel, A. J., & Yehya, N. (2022). High Frequency Percussive Ventilation in Viral Bronchiolitis: Do We Need a Standardized Approach to HFPV Management? Https://Home.Liebertpub.Com/Rcare, 67(7), 893–894. https://doi.org/10.4187/RESPCARE.10247
- White, B. R., Cadotte, N., McClellan, E. B., Presson, A. P., Bennett, E., Smith, A. G., & Aljabari, S. (2022). High-Frequency Percussive Ventilation in Viral Bronchiolitis. Respiratory Care, 67(7), 781–788. https://doi.org/10.4187/respcare.09350
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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.
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