Hemodynamic effects of high-frequency oscillatory ventilation in children.

The purpose of this study was to evaluate the acute hemodynamic effects of transitioning a patient from conventional mechanical ventilation (CMV) to high-frequency oscillatory ventilation (HFOV). Our hypothesis was that hemodynamic status would not be adversely affected by such a change. Ten pediatric patients with acute hypoxemic respiratory failure and a thermodilution pulmonary arterial catheter in place were prospectively evaluated on the transition from CMV to HFOV. Hemodynamic and respiratory data were obtained before and within 1 hour of transition to HFOV with a "high-volume" ventilation strategy. On CMV, the mean oxygenation index of the patients was 18+/-4. Despite increases in mean airway pressure and decreases in mean arterial pressure and systemic vascular resistance on HFOV, there was no change in pulmonary circulation variables, cardiac index, or oxygen delivery. We concluded that in pediatric patients with acute respiratory failure and unstable cardiovascular status, the transition from CMV to HFOV was not accompanied by a decrease in cardiac function or oxygen delivery.