Advances and Controversies in the Application of High-Frequency Oscillatory Ventilation in Pediatric Acute Respiratory Distress Syndrome

急性呼吸窘迫综合征(Acute Respiratory Distress Syndrome, ARDS)是一种常见且致死率高的肺部疾病，常规机械通气对改善生存率的效果有限，而高频振荡通气(high frequency oscillatory ventilation, HFOV)作为肺保护性通气模式，已广泛用于ARDS的治疗。尽管HFOV在理论上具有潜在优势，但其对儿童急性呼吸窘迫综合征(Pediatric ARDS, PARDS)的疗效仍存在争议。本文综述了HFOV在PARDS中的应用研究进展，探讨了HFOV的核心原理、早期和晚期应用时机对预后的影响、HFOV与容量保证(HFOV-VG)模式的联合应用效果以及其潜在的风险与不良反应，并提出了未来研究方向。Acute Respiratory Distress Syndrome (ARDS) is a common and high-mortality pulmonary disease, and conventional mechanical ventilation has limited efficacy in improving survival rates. High-frequency oscillatory ventilation (HFOV), as a lung-protective ventilation strategy, has been widely used in the treatment of ARDS. Despite its theoretical advantages, the efficacy of HFOV in pediatric ARDS (PARDS) remains controversial. This review summarizes the research progress on the application of HFOV in PARDS, discussing the core principles of HFOV, the impact of early and late application timing on prognosis, the combined effect of HFOV and volume guarantee (HFOV-VG) mode, as well as its potential risks and adverse effects, and proposes directions for future research.