Target tidal volume incompletely describes mechanical dose during high-frequency oscillatory ventilation.

Volume guarantee can stabilize oscillatory tidal volume, but the target value alone does not describe the mechanical conditions required to achieve it. Bench data show that frequency, pressure amplitude, mean airway pressure, inspiratory-expiratory ratio, and airway resistance influence delivered tidal volume. Future HFOV-volume guarantee studies should therefore report target and achieved tidal volume together with frequency, amplitude, airway resistance proxies, endotracheal tube size, and carbon dioxide response.