Safety and efficacy of high frequency jet ventilation: a systematic and narrative review

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Abstract High frequency jet ventilation (HFJV) is an unconventional mechanical ventilation technique increasingly utilized in complex medical fields such as airway surgery and intensive care. This systematic review analyzes the safety and efficacy of HFJV, focusing on its application in both adult and pediatric populations. Through systematic searches of PubMed, Cochrane Library, and Livivo databases, 41 studies meeting the inclusion criteria were identified. Key parameters analyzed included complications, CO₂ and O₂ levels, pH values, FiO₂, treatment course, and duration. Studies were selected that evaluated HFJV both as a standalone method and in comparison, with conventional ventilation techniques. The findings suggest that HFJV offers significant advantages in maintaining low alveolar pressures and improving surgical conditions, particularly in procedures requiring minimal organ movement. While most studies reported no significant difference in complication rates between HFJV and conventional ventilation, HFJV was associated with a more favorable treatment course and duration. Despite these positive outcomes, the data highlight challenges in the use of HFJV, particularly the complexity of the technique and the necessity for precise ventilatory parameter settings. Inappropriate settings can lead to suboptimal ventilation and oxygenation, increasing the risk of complications such as pneumothorax. This review underscores the need for further research to optimize HFJV application and better understand its long-term clinical impacts. The insights gained provide valuable guidance for future clinical use. Key Message This systematic review examines the safety and efficacy of high frequency jet ventilation in adult and paediatric patients. The findings indicate that HFJV offers advantages in complex procedures, such as airway surgery and intensive care, by providing lower alveolar pressures and improved surgical conditions without significantly increased complication rates compared to conventional ventilation. However, HFJV requires precise parameter controls to avoid complications such as pneumothorax. Further research is needed to optimise its long-term clinical effects.

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