PedsCrit High-Frequency Percussive Ventilation (HFPV or VDR) with Dr. John Lin (2/2)
Sep 15, 2025
Dr. John Lin, a Professor of Pediatrics and Medical Director of Respiratory Care, shares his insights on high-frequency percussive ventilation (HFPV). He explains how the VDR ventilator works, mapping its settings to conventional terms. Listeners learn about safe percussive frequency ranges, the importance of I-time adjustments for effective ventilation, and patient management during transitions to HFPV. Dr. Lin also discusses contraindications, weaning strategies, and updates on its usage trends, emphasizing the need for clinicians to be aware of future equipment availability.
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Average Vs Maximal Inspiratory Pressure
- VDR reports both average and maximal inspiratory pressures; AIP approximates conventional PIP.
- Maximal inspiratory pressure is measured at the endotracheal tube and overestimates alveolar pressure.
Practical Starting Settings
- When switching from pressure control, set AIP ~3–5 cmH2O below prior PIP and match AEP to prior PEEP.
- Start convective rate by age and begin FiO2 at 100% then wean toward baseline.
Age‑Based Time And Frequency Rules
- Set convective (capital I/E) by age: infants ~30, toddlers ~20, teens ~15 using seconds to calculate rate.
- Choose percussive frequency mid‑range by age (400–700 bpm) and start FiO2 high during transition.