What is the role of high-frequency ventilation in adult respiratory distress syndrome?

The goal of positive-pressure mechanical ventilation is to provide respiratory support to a patient while allowing the underlying diseased lungs to heal. Research using both animal models and humans suggests that positive-pressure ventilation can injure the lung through both overdistension and under recruitment. Theoretically,the ultimate lung-protective strategy would consist of very small tidal volumes to avoid pressure swings while maintaining alveolar recruitment. High-frequency ventilation provides such a strategy of mechanical ventilation. This article examines the utility of using high-frequency modes of mechanical ventilation in supporting the patient with ARDS.