Venovenous extracorporeal membrane oxygenation for respiratory failure refractory to high frequency percussive ventilation.

Background: High frequency percussive ventilation (HFPV) has demonstrated improvements in gas exchange, but not in clinical outcomes.

Objectives: We utilize HFPV in patients failing conventional ventilation (CV), with rescue venovenous extracorporeal membrane oxygenation (VV ECMO) reserved for failure of HFPV, and we describe our experience with such a strategy.

Methods: All adult patients (age >18 years) placed on HFPV for failure of CV at a single institution over a 10-year period were included.

The use of high-frequency percussive ventilation after cardiac surgery significantly improves gas exchange without impairment of hemodynamics.

Objective: Respiratory failure represents a significant source of morbidity and mortality for surgical patients. High-frequency percussive ventilation (HFPV) is emerging as a potentially effective rescue therapy in patients failing conventional mechanical ventilation (CMV). Use of HFPV is often limited by concerns for potential effects on hemodynamics, which is particularly tenuous in patients immediately after cardiac surgery.

The Use of High-Frequency Percussive Ventilation for Whole-Lung Lavage: A Case Report.

Whole-lung lavage (WLL) remains the gold standard in the treatment of pulmonary alveolar proteinosis. However, anesthetic management during WLL can be challenging because of the risk of intraoperative hypoxemia and various cardiorespiratory complications of 1-lung ventilation. Here, we describe a novel strategy involving the application of high-frequency percussive ventilation using a volumetric diffusive respirator (VDR-4) during WLL in a 47-year-old woman with pulmonary alveolar proteinosis.

High-Frequency Percussive Ventilation Rescue Therapy in Morbidly Obese Patients Failing Conventional Mechanical Ventilation.

Background: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality.

Methods: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV.

High-Frequency Percussive Ventilation Facilitates Weaning from Extracorporeal Membrane Oxygenation in Adults.

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV.

High-frequency percussive ventilation in cardiac surgery patients failing mechanical conventional ventilation.

Objectives: Failure of mechanical conventional ventilation (MCV) after cardiac surgery portends a dismal prognosis, with extracorporeal membrane oxygenation frequently utilized as a salvage therapy. We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue therapy for hypoxaemia refractory to MCV after cardiac surgery.

Methods: In a 6-year retrospective analysis from 2009 to 2015, we identified 16 subjects who required HFPV after cardiac surgery.

Update in Management of Severe Hypoxemic Respiratory Failure.

Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao/Fio < 150 mm Hg (ie, severe-moderate and severe ARDS).

Use of High-Frequency Percussive Ventilation to Expand Organ Donor Pool.

A 34-year-old woman was brought in to the emergency department after a motor vehicle accident. She had signs of traumatic head injury with Glasgow Coma Scale score of 3, and her neurological examination was consistent with brain death. She was persistently hypoxic on conventional mechanical ventilation and high-frequency percussive ventilation was initiated.