• Nejla Ben Jaballah, Ammar Khaldi, Khaled Mnif, Asma Bouziri, Sarra Belhadj, Asma Hamdi, and Wassim Kchaou.
• Pediatric Intensive Care Unit, Children's Hospital of Tunis, Tunis, Tunisia.
• Pediatr Crit Care Me. 2006 Jul 1;7(4):362-7.

ObjectiveTo evaluate the effectiveness of high-frequency oscillatory ventilation (HFOV) in pediatric patients with acute respiratory failure, failing conventional ventilation.DesignA prospective, clinical study.SettingTertiary care pediatric intensive care unit.PatientsTwenty pediatric patients (ages 12 days to 5 yrs) with acute respiratory failure (pneumonia, 14; sepsis with acute respiratory distress syndrome, 3; pulmonary edema as a complication of upper airway obstruction, 2; salicylate intoxication with acute respiratory distress syndrome, 1), failing conventional ventilation (median alveolar-arterial oxygen difference [P(A-a)O2] 578 [489-624] torr, median oxygenation index 26 [21-32].InterventionsHFOV was instituted after a median length of conventional ventilation of 15.5 (3.3-43.5) hrs.Measurements And Main ResultsVentilator settings, arterial blood gases, oxygenation index, and P(A-a)O2 were recorded before HFOV (0 hrs) and at predetermined intervals during HFOV and compared using the one-way Friedman rank-sum procedure and a two-tailed Wilcoxon matched-pairs test. Initiation of HFOV caused a significant decrease in FiO2 at 1 hr that continued to 24 hrs (p ConclusionsIn pediatric patients with acute respiratory failure, failing conventional ventilation, HFOV improves gas exchange in a rapid and sustained fashion. However, randomized controlled trials are needed to identify its benefits over conventional modes of mechanical ventilation.

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