Which ARDS rescue therapy involves high-frequency oscillation?

High-frequency oscillatory ventilation (HFOV) is a form of mechanical ventilation that employs rapid oscillations of airflow to effectively oxygenate and ventilate patients, particularly those with severe respiratory distress such as acute respiratory distress syndrome (ARDS). This therapy utilizes very small tidal volumes and high respiratory rates, which can help reduce ventilator-induced lung injury by minimizing the pressure variations that traditional methods might cause.

HFOV has specific physiological advantages, including improved control over airway pressure, recruitment of collapsed alveoli, and the ability to maintain lung recruitment while minimizing barotrauma risk. This therapy is particularly useful in patients who do not respond to conventional ventilation strategies and require more aggressive rescue techniques to improve oxygenation and avoid further lung injury.

While other therapies listed may play critical roles in treating ARDS, such as ECMO, which provides extra corporeal circulation and oxygenation, or APRV which allows spontaneous breathing with higher mean airway pressures, HFOV specifically stands out as the technique that directly involves high-frequency oscillation as a method of providing respiratory support. Hence, it is recognized as a distinct and effective rescue therapy for ARDS-related respiratory failure.