High-frequency oscillatory ventilation (HFOV) is a life-support technique used in severe respiratory failure, delivering rapid, small breaths to improve lung recruitment while reducing barotrauma. It is indicated for conditions like ventilator-associated lung injury, acute respiratory distress syndrome, and refractory hypoxemia, but is contraindicated in obstructive airway diseases and significant intracranial issues. Key settings include bias flow, mean airway pressure, amplitude, frequency, and inspiratory time, with potential complications such as hypotension and pneumothorax.

1. HFOV
High-Frequency Oscillatory Ventilation

2. CONTENTS
➔ Introduction
➔ Types of HFV
➔ What is HFOV?
➔ Indications of HFOV
➔ Contraindication of HFOV
➔ Settings &Parameters in HFOV
➔ Complication of HFOV

3. INTRODUCTION
DEFINITION OF HFV
High-frequency ventilation (HFV) is a type of ventilation that is utilized when
conventional ventilation fails. It is a technique where the set respiratory rate
greatly exceeds the normal breathing rate. In this rescue strategy, the tidal
volume delivered is significantly less and can also be less than dead space
ventilation.

4. TYPES OF HFV
Types of HFV are
1) High-frequency oscillatory ventilation(HFOV)
2) High-frequency positive pressure ventilation(HFPPV)
3) High-frequency jet ventilation(HFJV)
4) High-frequency percussive ventilation(HFPV)

5. WHAT IS HFOV?
DEFINITION OF HFOV
HFOV stands for High-Frequency Oscillatory Ventilation. It's a type of
mechanical ventilation used in intensive care units to support patients with
severe respiratory failure. HFOV delivers very small, rapid breaths at a set
frequency, allowing for greater lung recruitment and oxygenation while
minimizing barotrauma.

6. INDICATIONS OF HFOV
❏ Ventilator-associated lung injury
❏ Alveolar hemorrhage
❏ Large air leak with inability to keep lungs open
❏ Abdominal Compartment Syndrome
❏ Failure of conventional mechanical ventilation
❏ Refractory hypoxemia
❏ Increased intracranial pressure
❏ Persistent pulmonary hypertension
❏ Acute Respiratory Distress Syndrome
❏ Pulmonary Interstitial Emphysema
❏ Meconium aspiration
❏ Pulmonary hypoplasia
❏ Bronchopulmonary fistulae

7. CONTRAINDICATIONS OF HFOV
❏ Obstructive airway disease
❏ TBI/intracranial haemorrhage
❏ Hemodynamic compromise

8. CHEST WIGGLE FACTOR
❏ Infant-umblicus
❏ Children-pubic symphysis
❏ Adult-mid thigh

9. SETTINGS AND PARAMETERS IN HFOV
The settings in hfov are
1. Bias flow
2. Mean airway pressure
3. Amplitude
4. Frequency
5. Inspiratory time

11. 1.BIAS FLOW
❖ It is also called base flow
❖ Its supplies oxygen and remove exhale air
❖ Generate the Paw
❖ Initial flow 20L/min
❖ Maximum upto 60L/min
Parameters
❖ premature-10-15L/min
❖ <1yrs-15-25L/min
❖ 1 to 8 yrs-15-30L/min
❖ >8 yrs-25-40L/min

12. 2.MEAN AIRWAY PRESSURE
Its used to optmize lung volume & thus improves alveolar surfacearea for gas
exchange.
1) Neonates: 8-10cmH2o
2) infants:15-20cmH2o

13. 3.AMPLITUDE
❖ Distant the diaphragm moves
❖ Set the Pswing around MAP
❖ If is too low-under ventilation
❖ If its too high-VILI
❖ Determines Vt
PARAMETERS
❖ wt<2-0kg-2.5
❖ Wt2.1-2.5kg-3.0
❖ Wt2.6-4.0kg-4.0
❖ Wt4.6-5.0kg-5.0
❖ Wt5.1-10kg-6.0
❖ wt>20kg-7.0

14. 4.FREQUENCY
❖ Measured in Hertz(HZ)
❖ 1HZ=1cycle/sec=60breaths/min
❖ Increase in amplitude=decreasein frequency
❖ Decrease of age/wt=increase in frequency
❖ Decrease of compliance=increase in frequency
PARAMETERS
❖ Preterm neonates-15HZ
❖ Term neonates-12HZ
❖ infant/child-10HZ
❖ Older child-8HZ

15. 5.INSPIRATORY TIME
❖ Similar to conventional
❖ Ratio 1:2
❖ Insp time is 33%
❖ Increase in time will leads to air trapping

16. COMPLICATIONS OF HFOV
❖ Irritation
❖ Hypotension
❖ Pneumothorax
❖ ETT obstruction due to secretion
❖ Intracranial hemorrhage
❖ Bronchopulmonary dysplasia
❖ Necrotizing tracheo bronchitis

17. THANK YOU