TY - JOUR T1 - High-frequency oscillatory ventilation – A safe procedure for COPD patients? JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p1988 AU - Sven Pulletz AU - Ute Achtzehn AU - Andreas Pechmann AU - Ernst Schmidt AU - Michael Quintel AU - Norbert Weiler AU - Inéz Frerichs Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p1988.abstract N2 - Introduction: High-frequency oscillatory ventilation (HFOV) is an alternative type of mechanical ventilation. HFOV is usually considered as not indicated in patients with obstructive lung disease because of the theoretical risk of air trapping and hyperinflation.Aim and objectives: Intention of this study was to establish if HFOV can safely be applied in patients with exacerbation of chronic obstructive pulmonary disease and hypercapnic respiratory failure.Methods: Ten patients with acutely exacerbated chronic obstructive pulmonary disease (GOLD stages II-IV) requiring intensive care treatment who failed on non-invasive ventilation were studied. After initial conventional mechanical ventilation (CMV) of less than 72 hours all patients were transferred to HFOV for 24 hours and then back to CMV.Main results: Regional lung aeration and ventilation were assessed by electrical impedance tomography. HFOV was tolerated well, no adverse effects were observed. Effective CO2 elimination and oxygenation were achieved. Arterial partial pressure of CO2 was 52±13 mmHg (mean ± SD) during CMV before transition to HFOV and 47±9 mmHg by the end of the 24-hour period of HFOV. Ventilation was more homogeneously distributed during HFOV than during initial CMV. No signs of hyperinflation induced by HFOV were identified. Higher respiratory system compliance and tidal volume were found during CMV after 24 hours of HFOV than before.Conclusions: Contrary to present recommendations on the use of HFOV in adult patients our pilot study indicates that this type of mechanical ventilation can safely be used in patients with chronic obstructive lung disease. ER -