• Anelise Dentzien Pinzon, Taís Sica da Rocha, Cláudia Ricachinevsky, Jefferson Pedro Piva, and Gilberto Friedman.
• Pediatric Intensive Care Unit, Hospital de Criança Santo Antonio, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil.
• Rev Assoc Med Bras. 2013 Jul 1;59(4):368-74.

ObjectiveTo describe the effects of high-frequency oscillatory ventilation (HFOV) as a rescue ventilatory support in pediatric patients with acute respiratory distress syndrome (ARDS).MethodsTwenty-five children (1 month < age < 17 years) admitted to a university hospital pediatric intensive care unit (ICU) with ARDS and submitted to HFOV for a minimum of 48 hours after failure of conventional mechanical ventilation were assessed.ResultsTwenty eight days after the onset of ARDS, the mortality rate was 52% (13/25). Over the course of 48 hours, the use of HFOV reduced the oxygenation index [38 (31-50) vs. 17 (10-27)] and increased the ratio of partial arterial pressure O2 and fraction of inspired O2 [65 [44-80) vs. 152 (106-213)]. Arterial CO2 partial pressure [54 (45-74) vs. 48 (39-58) mmHg] remained unchanged. The mean airway pressure ranged between 23 and 29 cmH2O. HFOV did not compromise hemodynamics, and a reduction in heart rate was observed (141±32 vs. 119±22 beats/min), whereas mean arterial pressure (66±20 vs. 71±17 mmHg) and inotropic score [44 (17-130) vs. 20 (16-75)] remained stable during this period. No survivors were dependent on oxygen.ConclusionHFOV improves oxygenation in pediatric patients with ARDS and severe hypoxemia refractory to conventional ventilatory support.Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

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