{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:55:29Z","timestamp":1761710129378,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Reports"],"abstract":"<jats:p>High-flow oscillatory ventilation (HFOV) is a common rescue treatment in infants and children with respiratory failure. This type of ventilation is an effective technique in numerous diseases that affect a child in the postnatal period, such as ARDS, meconium aspiration syndrome (MIS), postnatal pulmonary bleeding and idiopathic pulmonary hypertension (IPH). Although this ventilation technique is commonly recognized as a valuable therapeutic option in the general pediatric population, this is not the same for children with congenital cardiovascular diseases. The key mechanism of oscillatory ventilation is continuous positive pressure administered within the airways via a small tidal volume at high frequency. Tidal volumes are between 1 and 3 mL\/kg delivered at 5\u201315 Hz, equivalent to 300\u2013900 breaths per minute. A few older studies conducted on humans and animals highlight that HFOV may be dangerous for congenital heart patients. According to these evidences, hemodynamic parameters such as blood pressure, wedge pressure, central venous pressure, heart rate and inotrope level can be dangerously changed for patients with congenital heart disease; therefore, oscillatory ventilation should be avoided. Numerous retrospective studies have pointed out how oscillatory ventilation constitutes a valid therapeutic option in children with congenital heart disease. Recently, new evidences have highlighted how hemodynamic parameters are modified in a non-significant way by this type of ventilation, remaining beneficial as in the normal pediatric population. This narrative review aims to describe the mechanisms of oscillatory ventilation and collect all the available evidences to support its use in pediatric patients with congenital heart problems.<\/jats:p>","DOI":"10.3390\/pediatric16040079","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T05:47:33Z","timestamp":1729748853000},"page":"925-933","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["High-Flow Oscillatory Ventilation: A Possible Therapeutic Option for Pediatric Patients with Cardiovascular Diseases"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4565-8220","authenticated-orcid":false,"given":"Stefano","family":"Scollo","sequence":"first","affiliation":[{"name":"Clinical Critical Care Fellow\u2014PGY1, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-7554","authenticated-orcid":false,"given":"Luigi","family":"La Via","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care 1, Azienda Ospedaliero Universitaria Policlinico, G. Rodolico\u2014San Marco, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5600-9560","authenticated-orcid":false,"given":"Piero","family":"Pavone","sequence":"additional","affiliation":[{"name":"Clinical Pediatrics Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Piastra","sequence":"additional","affiliation":[{"name":"Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Conti","sequence":"additional","affiliation":[{"name":"Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-1648","authenticated-orcid":false,"given":"Carmelo","family":"Minardi","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care 1, Azienda Ospedaliero Universitaria Policlinico, G. Rodolico\u2014San Marco, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"40","DOI":"10.29390\/cjrt-2019-004","article-title":"High-frequency oscillatory ventilation: A narrative review","volume":"55","author":"Meyers","year":"2019","journal-title":"Can. J. Respir. Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1038\/s41390-021-01639-8","article-title":"High-frequency ventilation in preterm infants and neonates","volume":"93","author":"Ackermann","year":"2023","journal-title":"Pediatr. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.4187\/respcare.04255","article-title":"Airway Pressure Release Ventilation and High-Frequency Oscillatory Ventilation: Potential Strategies to Treat Severe Hypoxemia and Prevent Ventilator-Induced Lung Injury","volume":"60","author":"Facchin","year":"2015","journal-title":"Respir. Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S209","DOI":"10.1097\/01.CCM.0000156794.96880.DF","article-title":"Sedation, analgesia, and neuromuscular blockade for high-frequency oscillatory ventilation","volume":"33","author":"Sessler","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_5","first-page":"595","article-title":"Respiratory controversies in the critical care setting. Does high-frequency ventilation offer benefits over conventional ventilation in adult patients with acute respiratory distress syndrome?","volume":"52","author":"Fessler","year":"2007","journal-title":"Respir. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1177\/1060028013503121","article-title":"Use of sedation and neuromuscular blockers in critically ill adults receiving high-frequency oscillatory ventilation","volume":"47","author":"Burry","year":"2013","journal-title":"Ann. Pharmacother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1001\/jamapediatrics.2013.4463","article-title":"Comparison of high-frequency oscillatory ventilation and conventional mechanical ventilation in pediatric respiratory failure","volume":"168","author":"Gupta","year":"2014","journal-title":"JAMA Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1159\/000353376","article-title":"High-frequency oscillatory ventilation with low oscillatory frequency in pulmonary interstitial emphysema","volume":"104","author":"Squires","year":"2013","journal-title":"Neonatology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"R430","DOI":"10.1186\/cc3737","article-title":"High frequency oscillatory ventilation compared with conventional mechanical ventilation in adult respiratory distress syndrome: A randomized controlled trial [ISRCTN24242669]","volume":"9","author":"Bollen","year":"2005","journal-title":"Crit. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4037\/ajcc2009303","article-title":"High-frequency oscillatory ventilation as a rescue therapy for adult trauma patients","volume":"18","author":"Briggs","year":"2009","journal-title":"Am. J. Crit. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1097\/00003246-200107000-00011","article-title":"Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome","volume":"29","author":"Mehta","year":"2001","journal-title":"Crit. Care Med."},{"key":"ref_12","first-page":"Iii364","article-title":"High-frequency jet ventilation improves cardiac function after the Fontan procedure","volume":"84","author":"Meliones","year":"1991","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"R259","DOI":"10.1186\/cc10521","article-title":"High-frequency oscillatory ventilation and short-term outcome in neonates and infants undergoing cardiac surgery: A propensity score analysis","volume":"15","author":"Bojan","year":"2011","journal-title":"Crit. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e272","DOI":"10.1097\/PCC.0000000000003211","article-title":"Hemodynamic Effects of a High-Frequency Oscillatory Ventilation Open-Lung Strategy in Critically Ill Children with Acquired or Congenital Cardiac Disease","volume":"24","author":"Curley","year":"2023","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1002\/ppul.25447","article-title":"Application of high-frequency oscillation ventilation combined with volume guarantee in infants with acute hypoxic respiratory failure after congenital heart surgery","volume":"56","author":"Zheng","year":"2021","journal-title":"Pediatr. Pulmonol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1001\/jama.2017.21907","article-title":"Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment","volume":"319","author":"Fan","year":"2018","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1097\/01.CCM.0000155789.52984.B7","article-title":"High-frequency oscillatory ventilation: Mechanisms of gas exchange and lung mechanics","volume":"33","author":"Pillow","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/jpc.12398","article-title":"Dr\u00e4ger VN500\u2019s oscillatory performance has a frequency-dependent threshold","volume":"50","author":"John","year":"2014","journal-title":"J. Paediatr. Child Health"},{"key":"ref_19","unstructured":"Keszler, M., Pillow, J.J., and Courtney, S.E. (2015). Pediatric and Neonatal Mechanical Ventilation, Springer."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1097\/CCM.0000000000001278","article-title":"High-Frequency Oscillatory Ventilation in Pediatric Acute Lung Injury: A Multicenter International Experience","volume":"43","author":"Rettig","year":"2015","journal-title":"Crit. Care Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.21037\/tp-20-332","article-title":"A narrative review of advanced ventilator modes in the pediatric intensive care unit","volume":"10","author":"Miller","year":"2021","journal-title":"Transl. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"845","DOI":"10.4187\/respcare.08691","article-title":"High-Frequency Jet Ventilation in Neonatal and Pediatric Subjects: A Narrative Review","volume":"66","author":"Miller","year":"2021","journal-title":"Respir. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1126\/science.6771872","article-title":"Effective pulmonary ventilation with small-volume oscillations at high frequency","volume":"209","author":"Slutsky","year":"1980","journal-title":"Science"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/MCC.0000000000000387","article-title":"High-frequency oscillatory ventilation: Still a role?","volume":"23","author":"Ng","year":"2017","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s13052-017-0436-y","article-title":"Management of pneumothorax in hemodynamically stable preterm infants using high frequency oscillatory ventilation: Report of five cases","volume":"43","author":"Aurilia","year":"2017","journal-title":"Ital. J. Pediatr."},{"key":"ref_26","first-page":"1","article-title":"High frequency oscillatory ventilation","volume":"261","author":"Jarvis","year":"2012","journal-title":"Anaesth. Tutor. Week"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1542\/peds.89.1.5","article-title":"Prospective randomized comparison of high-frequency oscillatory and conventional ventilation in respiratory distress syndrome","volume":"89","author":"Clark","year":"1992","journal-title":"Pediatrics"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1164\/rccm.2108052","article-title":"High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: A randomized, controlled trial","volume":"166","author":"Derdak","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1164\/rccm.201703-0475ED","article-title":"High-Frequency Oscillation in Acute Respiratory Distress Syndrome. The End of the Story?","volume":"196","author":"Vincent","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1152\/jappl.2001.91.4.1836","article-title":"Comparison of lung protection strategies using conventional and high-frequency oscillatory ventilation","volume":"91","author":"Imai","year":"2001","journal-title":"J. Appl. Physiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3390\/epidemiologia5030032","article-title":"The Global Burden of Sepsis and Septic Shock","volume":"5","author":"Sangiorgio","year":"2024","journal-title":"Epidemiologia"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1056\/NEJMoa020432","article-title":"High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity","volume":"347","author":"Johnson","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_33","unstructured":"AARC Clinical Practice Guidelines (2010). Endotracheal suctioning of mechanically ventilated patients with artificial airways 2010. Respir. Care, 55, 758\u2013764."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/01.CCM.0000155785.23200.9E","article-title":"Combining high-frequency oscillatory ventilation and recruitment maneuvers in adults with early acute respiratory distress syndrome: The Treatment with Oscillation and an Open Lung Strategy (TOOLS) Trial pilot study","volume":"33","author":"Ferguson","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1177\/0885066609335728","article-title":"High-frequency oscillatory ventilation (HFOV) and airway pressure release ventilation (APRV): A practical guide","volume":"24","author":"Stawicki","year":"2009","journal-title":"J. Intensive Care Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13613-019-0492-0","article-title":"Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children","volume":"9","author":"Kamp","year":"2019","journal-title":"Ann. Intensive Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1159\/000533318","article-title":"Point-of-Care Ultrasound versus Chest X-ray for Determining Lung Expansion Based on Rib Count in High-Frequency Oscillatory Ventilation","volume":"120","author":"Sahin","year":"2023","journal-title":"Neonatology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/S0012-3692(15)31165-X","article-title":"High-frequency oscillatory ventilation in adults: The Toronto experience","volume":"126","author":"Mehta","year":"2004","journal-title":"Chest"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2990","DOI":"10.1097\/01.CCM.0000242758.37427.16","article-title":"Hemodynamic effects of different lung-protective ventilation strategies in closed-chest pigs with normal lungs","volume":"34","author":"Roosens","year":"2006","journal-title":"Crit. Care Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1007\/s00246-013-0655-y","article-title":"High-frequency oscillatory ventilation for cardiac surgery children with severe acute respiratory distress syndrome","volume":"34","author":"Li","year":"2013","journal-title":"Pediatr. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/ppul.25195","article-title":"Hemodynamic effects of high-frequency oscillatory ventilation in preterm neonates with respiratory distress syndrome","volume":"56","author":"Ayoub","year":"2021","journal-title":"Pediatr. Pulmonol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/jocs.16163","article-title":"Effect of postoperative administration of inhaled nitric oxide combined with high-frequency oscillatory ventilation in infants with acute hypoxemic respiratory failure and pulmonary hypertension after congenital heart surgery: A retrospective cohort study","volume":"37","author":"Huang","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1017\/S1047951122002396","article-title":"Rescue high-frequency oscillatory ventilation combined with intermittent mandatory ventilation for infants with acute respiratory distress syndrome after congenital heart surgery","volume":"33","author":"Zheng","year":"2023","journal-title":"Cardiol. Young"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/(SICI)1099-0496(199806)25:6<371::AID-PPUL3>3.0.CO;2-K","article-title":"Hemodynamic effects of high-frequency oscillatory ventilation in children","volume":"25","author":"Goodman","year":"1998","journal-title":"Pediatr. Pulmonol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/BF01706204","article-title":"Hemodynamic effects of high-frequency oscillatory ventilation in severe pediatric respiratory failure","volume":"21","author":"Levin","year":"1995","journal-title":"Intensive Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00003246-200001000-00038","article-title":"Conventional ventilation versus high-frequency oscillation: Hemodynamic effects in newborn babies","volume":"28","author":"Simma","year":"2000","journal-title":"Crit. Care Med"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"F172","DOI":"10.1136\/fn.74.3.F172","article-title":"Haemodynamic changes during high frequency oscillation for respiratory distress syndrome","volume":"74","author":"Laubscher","year":"1996","journal-title":"Arch. Dis. Child Fetal Neonatal Ed."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/00003246-199706000-00008","article-title":"High-frequency oscillatory ventilation for adult respiratory distress syndrome\u2014A pilot study","volume":"25","author":"Fort","year":"1997","journal-title":"Crit. Care Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1186\/cc10529","article-title":"High-frequency oscillatory ventilation and pediatric cardiac surgery: Yes, we can!","volume":"15","author":"Kneyber","year":"2011","journal-title":"Crit. Care"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1186\/cc10605","article-title":"High-frequency oscillatory ventilation after cardiac surgery: A treatment for all ages","volume":"16","author":"Tripathi","year":"2012","journal-title":"Crit. Care"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"60","DOI":"10.5114\/ait.2023.126219","article-title":"High-frequency oscillatory ventilation for respiratory failure after congenital heart surgery: A retrospective analysis","volume":"55","author":"Kumar","year":"2023","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3847","DOI":"10.1053\/j.jvca.2022.06.010","article-title":"Effect of High-Frequency Oscillatory Ventilation, Combined with Prone Positioning, in Infants with Acute Respiratory Distress Syndrome After Congenital Heart Surgery: A Prospective Randomized Controlled Trial","volume":"36","author":"Zheng","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_53","first-page":"Cd005055","article-title":"Inhaled nitric oxide for the postoperative management of pulmonary hypertension in infants and children with congenital heart disease","volume":"7","author":"Bizzarro","year":"2005","journal-title":"Cochrane Database Syst. Rev."}],"container-title":["Pediatric Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7503\/16\/4\/79\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:19:17Z","timestamp":1760113157000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7503\/16\/4\/79"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,24]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["pediatric16040079"],"URL":"https:\/\/doi.org\/10.3390\/pediatric16040079","relation":{},"ISSN":["2036-7503"],"issn-type":[{"type":"electronic","value":"2036-7503"}],"subject":[],"published":{"date-parts":[[2024,10,24]]}}}