Procon clinical debate Is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure 英文参考文献.docVIP

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Procon clinical debate Is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure 英文参考文献.doc

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Procon clinical debate Is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure 英文参考文献

Available online /content/6/3/183 Commentary Pro/con clinical debate: Is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure? Jeffrey M Singh1, Sangeeta Mehta2 and Robert M Kacmarek3 1Resident, Department of Medicine, Mount Sinai Hospital, Toronto, Canada 2Research Director, Medical/Surgical ICU, Department of Medicine, Mount Sinai Hospital, Toronto, Canada 3Director, Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts, USA Correspondence: Critical Care Forum Editorial Office, editorial@ Published online: 4 April 2002 Critical Care 2002, 6:183-185 ? 2002 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract In neonatal and pediatric intensive care units, high-frequency oscillatory ventilation (HFOV) has become an increasingly common therapy. This may not have been the case if researchers had not persisted in investigating the therapy after early disappointing clinical trials. Devices capable of providing this therapy to adults have become commercially available relatively recently. However, there are many questions that need to be answered regarding HFOV in adults: Is HFOV in adults superior to conventional mechanical ventilation? Who is the ideal candidate for HFOV? When should it be applied? What is the best technique with which to apply it? When should a patient on HFOV be converted back to conventional ventilation? What is the safety and efficacy of the device? As outlined in the following debate, there are several compelling arguments for and against the use of HFOV at this point in adults. Keywords acute respiratory failure, critical illness, high-frequency oscillatory ventilation, mechanical ventilation The scenario You have been asked to assist in the organization of and equipment purchases for a new large, state of the art, adult intensive care unit. You are encouraged to obtain leading edge equipment that offer