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Am J Perinatol 2018; 35(06): 545-548
DOI: 10.1055/s-0038-1637763
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

New Ventilator Strategies: High-Frequency Oscillatory Ventilation Combined with Volume Guarantee

M. Sánchez-Luna
1   Division of Neonatology, Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University of Madrid, Hospital General Universitario “Gregorio Marañón,” Madrid, Spain
,
N. González-Pacheco
1   Division of Neonatology, Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University of Madrid, Hospital General Universitario “Gregorio Marañón,” Madrid, Spain
,
J. Belik
2   Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
,
M. Santos
3   Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro Majadahonda, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
,
F. Tendillo
3   Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro Majadahonda, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
› Author Affiliations Funding Some of these studies were possible due to the grant by the Carlos III Instituto de Salud (FIS 14/00149).
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Publication History

Publication Date:
25 April 2018 (online)

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Abstract

High-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV–volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Different I:E ratios also can modify the effect of CO2 washout during HFOV combined with VG in a different way as without the VG modality. Finally, clinical use of this technique in newborn infants has demonstrated the possibility of using very high frequency combined with constant very low VThf to decrease the risk of lung trauma related to the ventilator.

Keywords

high-frequency oscillatory ventilation - volume guarantee ventilation - gas exchange - newborn ventilation - respiratory distress syndrome