Objective: To report the immediate use of High-Frequency Oscillatory ventilation in an adult acute respiratory distress syndrome.
Design: Case report.
Setting: Intensive care unit at the Military Teaching Hospital of Toulon.
Patient: A 64-yr-old Caucasian male who developed acute respiratory distress syndrome in the course of severe falciparum malaria.
Intervention: Initial use of HFO to minimise ventilator-induced lung injury.
Measurement and main results: Rapid improvement of PaO2/fraction of inspired oxygen from 172 mmHg (NIV) to 310 mmHg with HFO. No ventilator-induced injury on CT scan after 5 days of invasive ventilation.
Conclusion: In contrast with previous studies, we successfully used lung protective ventilation with HFO immediately. Further studies, with immediate, rather than rescue use of HFO ventilation, are needed.