PedsCrit High-Frequency Percussive Ventilation (HFPV or VDR) with Dr. John Lin (2/2)
Sep 15, 2025
Dr. John Lin, a Professor of Pediatrics and Medical Director of Respiratory Care, shares his insights on high-frequency percussive ventilation (HFPV). He explains how the VDR ventilator works, mapping its settings to conventional terms. Listeners learn about safe percussive frequency ranges, the importance of I-time adjustments for effective ventilation, and patient management during transitions to HFPV. Dr. Lin also discusses contraindications, weaning strategies, and updates on its usage trends, emphasizing the need for clinicians to be aware of future equipment availability.
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Flow And Time, Pressures Follow
- The VDR controls flow and time while pressures are a dependent variable of lung mechanics.
- Identical VDR settings produce different pressures in patients with different compliance.
Map VDR Pressures To Familiar Targets
- Target AIP like PIP and AEP like PEEP when converting from conventional modes.
- Use pulsatile flow to set AIP and demand plus oscillatory flow to achieve AEP.
Average Vs Maximal Inspiratory Pressure
- VDR reports both average and maximal inspiratory pressures; AIP approximates conventional PIP.
- Maximal inspiratory pressure is measured at the endotracheal tube and overestimates alveolar pressure.