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Editorial
. 2013 Feb 28;368(9):863-5.
doi: 10.1056/NEJMe1300103. Epub 2013 Jan 22.

High-frequency oscillatory ventilation on shaky ground

Atul Malhotra, Jeffrey M Drazen
Editorial

High-frequency oscillatory ventilation on shaky ground

Atul Malhotra et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Schematic Diagram of a Pressure-Volume Curve of a Lung in a Patient with the Acute Respiratory Distress Syndrome
The inflation limb (lower curve) and deflation limb (upper curve) differ from one another. The lower inflection point (A) defines the onset of alveolar recruitment from a state of substantial collapse; this is illustrated in the axial computed tomographic (CT) scan in Panel A. The upper inflection point (B) is thought to reflect the point at which recruitment is no longer occurring and overdistention may start to occur; this is illustrated in the axial CT scan in Panel B. High-frequency oscillatory ventilation (HFOV) is performed on the deflation limb of the pressure-volume curve; in this form of ventilation, small volumes should help to limit overdistention, and high mean airway pressures should prevent injury from repetitive collapse and reopening of the lung. CT scans adapted from Gattinoni et al.
See this image and copyright information in PMC

Comment on

  • High-frequency oscillation for acute respiratory distress syndrome.
    Young D, Lamb SE, Shah S, MacKenzie I, Tunnicliffe W, Lall R, Rowan K, Cuthbertson BH; OSCAR Study Group. Young D, et al. N Engl J Med. 2013 Feb 28;368(9):806-13. doi: 10.1056/NEJMoa1215716. Epub 2013 Jan 22. N Engl J Med. 2013. PMID: 23339638 Clinical Trial.
  • High-frequency oscillation in early acute respiratory distress syndrome.
    Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand L, Austin P, Zhou Q, Matte A, Walter SD, Lamontagne F, Granton JT, Arabi YM, Arroliga AC, Stewart TE, Slutsky AS, Meade MO; OSCILLATE Trial Investigators; Canadian Critical Care Trials Group. Ferguson ND, et al. N Engl J Med. 2013 Feb 28;368(9):795-805. doi: 10.1056/NEJMoa1215554. Epub 2013 Jan 22. N Engl J Med. 2013. PMID: 23339639 Clinical Trial.

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