High frequency ventilation

Abstract

Assisted ventilation has been the key strategy in the management of neonates with RDS. Traditionally convention ventilation is used for respiratory support in neonates. Concerns about ventilator associated lung trauma have led to innovation of new modes of ventilation. High frequency ventilation is a mode, in which a small tidal volume is delivered at very high rate. Theoretical advantage of such strategy is possibly less volutrauma as well less barotrauma, and hence decreased ventilator associated lung injury to an already diseased lung. Clinical studies of this intervention against conventional ventilation have shown mixed results and till date there is no consensus regarding definite superiority of this modality over conventional ventilation. Despite controversies, proponents of high frequency ventilation remain convinced about efficacy of this mode. Over last two decades, there has been significant advancement in conventional ventilation and sophisticated modes with better synchronization and small tidal volume delivery are now available. This innovation as well as approach of gentler non invasive ventilation has led the interest of neonatal community away from high frequency ventilation. Even in present era there remains a place for this mode of ventilation, particularly as rescue, in patients where conventional ventilation is failing.