Use of high frequency oscillatory ventilation (HFOV) in neurocritical care patients.

INTRODUCTION: Adult respiratory distress syndrome (ARDS) can be a common problem associated with the treatment of acute brain injury. High frequency oscillatory ventilation (HFOV) is a developing therapy for the treatment of ARDS in adult patients that can be life saving. However, often patients with acute, severe brain injury demonstrate intracranial hypertension (hICP) due to a variety of injuries (e.g., traumatic brain injury, mass lesion, acute hydrocephalus). There is concern over the use of HFOV due to its effects on intracranial pressure in patients with hICP.

METHODS: Retrospective case series study.

RESULTS: We describe the effects of HFOV on hemodynamics, respiratory function, and intracranial pressure in five patients with acute brain injury being treated for ARDS.

CONCLUSIONS: HFOV did not cause unmanageable or sustained increases in ICP in our series of patients. It appears HFOV may be a relatively safe and effective means of oxygenating patients with severe ARDS and concomitant hICP secondary to acute brain injury.