In what situation is high-frequency oscillatory ventilation (HFOV) typically used?

High-frequency oscillatory ventilation (HFOV) is a specialized mode of mechanical ventilation primarily utilized for patients with severe acute respiratory distress syndrome (ARDS). This technique is particularly effective in this context because ARDS often results in decreased lung compliance and severe hypoxemia due to fluid-filled alveoli and atelectasis. HFOV delivers small tidal volumes at a very high frequency, which helps to maintain lung recruitment and improve gas exchange while minimizing the risk of lung injury associated with traditional mechanical ventilation strategies that use larger tidal volumes.

By using small oscillatory movements, HFOV allows for continuous ventilation without the same degree of pressure variations that can cause barotrauma in compromised lungs, which is crucial for patients with ARDS. This method focuses on preventing the collapse of the alveoli and improving ventilation-perfusion matching, making it more suited for critically ill patients whereas other conditions, like mild asthma attacks or chronic obstructive pulmonary disease, usually do not require such an aggressive approach to ventilation.