儿童高频振荡通气技术的临床应用

The clinical application of high frequency oscillatory ventilation in children

高频通气是应用近于或少于解剖无效腔的潮气量（约为2 ml/kg），高的通气频率（目前公认通气频率≥正常4倍以上），在较低的气道压力下进行通气的一种特殊通气方法。与传统常频机械通气比较，既克服了呼气末肺泡萎缩和吸气末肺泡过度膨胀问题，又保证了肺有足够的弥散和氧交换。故而，近年来得到重症医学界的广泛关注，已越来越多地应用于临床。本文就高频通气的原理、分类、参数设置及临床应用适应证作一介绍。

High-frequency ventilation （HFV） is theoretically an ideal ventilatory mode for lung protection. It also delivers extremely small tidal volumes near to or less than the anatomically invalid cavity （ about 2ml/kg） at very high respiratory frequencies （ recognized ventilation frequency about 4 times more than the normal range）. Compared to the conventional mechanical ventilation, HFV makes use of lung-open mode, with low tidal volume, low airway pressure, low thoracic pressure and end-exhaling pressure effect, which can avoid recruitment/derecruitment of alveoli to reduce pressure injuries on lung tissue and airway. Nowadays ,more and more critical care practitioners implement this ventilation mode. We reviewed the principles, classification,parameters, and clinical indications of HFV in this article.