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High-frequency oscillatory ventilation in adults: Respiratory therapy issues

Higgins, Jason BS, RRT; Estetter, Bob RRT; Holland, Dean RRT; Smith, Brian RRT; Derdak, Stephen DO

doi: 10.1097/01.CCM.0000155922.78943.2D
Scientific Review

Objective: To summarize clinical information and assessment techniques relevant to respiratory therapists caring for adult patients on high-frequency oscillatory ventilation (HFOV).

Data Source: Review of observational studies, controlled trials, case reports, institutional experience, and hospital HFOV guidelines for adult patients.

Data Summary: Respiratory therapists require unique physical assessment skills and knowledge in managing patients on HFOV. Respiratory therapy procedures relevant to HFOV include setting endotracheal tube cuff leaks, performing lung recruiting maneuvers, endotracheal suctioning, and monitoring ventilator parameters. Respiratory therapists serve as essential team members in the creation and implementation of written HFOV guidelines (e.g., algorithms) to optimize patient care.

Conclusion: Respiratory therapy assessment and procedural skills are essential in providing optimal care to adult patients on HFOV.

From Parkland Health and Hospital System (JH, BE, DH, BS), Respiratory Care Department, Dallas, TX; and Pulmonary/Critical Care Medicine (SD), Wilford Hall Medical Center, Lackland AFB, TX.

© 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins