High Frequency Oscillatory Ventilation in Pediatric Patients: Where Are We?
Learning Objectives
Identify clinical and ventilator indicators of toxic conventional ventilation that warrant escalation to high‑frequency oscillatory ventilation in intubated pediatric patients
Explain the physiologic principles of lung recruitment, mean airway pressure, and oscillatory ventilation as they relate to airway protection and ventilator‑induced lung injury prevention
Apply safe techniques for manual ventilation, endotracheal suctioning, and lung recruitment when transitioning from conventional ventilation to HFOV
Analyze oxygenation, chest wall movement (“wiggle”), blood gas trends, and hemodynamic responses to guide adjustment of HFOV settings
Evaluate ventilation effectiveness and patient stability on HFOV to safely wean FiO₂, manage permissive hypercapnia, and avoid airway or cardiovascular compromise
Author(s)
John Arnold, MD
Senior Associate, Critical Care Medicine | Boston Children's Hospital
Senior Associate, Perioperative Anesthesia for the Department of Anesthesiology, Critical Care and Pain Medicine | Boston Children's Hospital
Traci Wolbrink, MD, MPH
Co-Director, OPENPediatrics; Co-Director, Center for Educational Excellence and Innovation; Program Director, Pediatric Critical Care Medicine Fellowship; Senior Associate in Critical Care Medicine | Boston Children’s Hospital
Associate Professor of Anaesthesia | Harvard Medical School
Aleksandra E. Olszewski, MD, MA
Assistant Professor of Critical Care Medicine and Pediatrics, Department of Critical Care Medicine | Children's Hospital of Pittsburgh
Jefferey Burns, MD, MPH
Assoc. Chief Medical Officer, Critical Care Services; Shapiro Chair in Critical Care Medicine, Division of Critical Care MedicineDirector, OPENPediatrics; Sr. Assoc. in Critical Care Medicine; Department of Anesthesiology, Critical Care & Pain Medicine | Boston Children's Hospital
Professor of Anesthesia | Harvard Medical School
Citation
Arnold J, Olszewski AE, Wolbrink TA, Burns JP. High Frequency Oscillatory Ventilation in Pediatric Patients: Where Are We?. 6/2015. Online Video. OPENPediatrics. https://learn.openpediatrics.org/learn/course/internal/view/elearning/3042/high-frequency-oscillatory-ventilation-in-pediatric-patients-where-are-we.