PedsCrit
High Frequency Oscillatory Ventilation (HFOV) with Dr. Martin Kneyber--Part 2
May 6, 2024
Dr. Martin Kneyber discusses the physiologic rationale for HFOV, patient populations benefiting from it, evidence supporting its use, expert patient management, and future research. Topics include mean airway pressure, chest movement in HFOV, corner frequency's impact on ventilation, optimizing strategies for oxygenation, and CO2 monitoring in critically ill children.
27:37
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Quick takeaways
- High frequency oscillatory ventilation requires precise parameter adjustments for optimal ventilation based on the corner frequency concept.
- Management of hypoxemic patients on HFOV includes recruitment maneuvers, prone positioning, and potential ECMO cannulation for refractory hypoxia.
Deep dives
Key Concepts of High-Frequency Oscillatory Ventilation
High-frequency oscillatory ventilation involves meticulous adjustments of key parameters such as mean airway pressure, frequency, and amplitude. The starting mean airway pressure is set based on the conventional mean airway pressure, while the frequency is determined by the corner frequency concept for optimal ventilation. Amplitude, considered a monitoring parameter, influences piston displacement and must be carefully managed. The approach emphasizes physiology over weight-dependent settings.
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