High Frequency Ventilation in the Adult

High-frequency ventilation (HFV) uses small tidal volumes at very high respiratory rates as a method for achieving mechanical ventilation. Two generally available methodologies are high-frequency jet ventilation and high-frequency oscillation. We review the physiology and clinical applications of HFV. HFV has been used extensively in pediatric and neonatal patients. In adult patients, HFV has been used in specialized clinical settings, including management of bronchopleural fistulae and airway procedures. It is our opinion that HFV also has application in a narrow range of adult patients with acute lung injury, perhaps as salvage strategy. The studies to date have not had sufficient statistical power to show what is likely to be a small benefit.