Abstract
Preliminary results with high-frequency oscillatory ventilation (HFOV) applied in neonates with severe hyaline membrane disease have been promising. Experimental data in surfactant-deficient animals have clearly demonstrated the advantages of HFOV, when compared with conventional mechanical ventilation, in improving gas exchange and pulmonary mechanics and in preventing barotrauma without impairing haemodynamics. Combination of HFOV and surfactant therapy appears to be very effective particularly if a high-volume strategy is used. There are only four prospective randomized trials reported in the literature. The beneficial effects of HFOV on oxygenation and ventilation are convincing, but the precise effects on cerebral circulation and on surfactant remain to be evaluated.
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