Ventilatory management of ARDS: high frequency oscillation and lung recruitment!

doi:10.1186/cc5018

Critical Care

Volume 10
Issue 4

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Commentary

Ventilatory management of ARDS: high frequency oscillation and lung recruitment!

Robert M Kacmarek

Harvard Medical School and Respiratory Care, Massachusetts General Hospital, Ellison 401, 55 Fruit Street, Boston MA. USA

author email corresponding author email

Critical Care 2006, 10:158doi:10.1186/cc5018


Published:	24 August 2006

See related research by David et al.; http://ccforum.com/content/10/4/R100

Abstract

Many aspects of ventilatory management in patients with ARDS are still controversial and one of the major controversies is should HFO or CMV ideally be used to manage this patients. As shown by David et al. when the two approaches to ventilatory support are applied using similar principles the physiologic outcomes appear to be similar. With both approaches the use of lung recruitment maneuvers early in ARDS (1 to 3 day) after hemodynamic stabilization in patients without baratrauma is promising. The key to managing ARDS regardless of mode is to use an open lung protective ventilatory strategy. It is not the mode that makes the difference, it is the approach used to apply the mode!