Conventional vs high-frequency ventilation for weaning from total liquid ventilation in lambs

•Weaning from total liquid ventilation is well tolerated.•Animals weaned using HFOV require more oxygen immediately after liquid ventilation.•Tidal volume distribution was affected by the type of ventilation used for weaning. To compare conventional gas ventilation (GV) and high-frequency oscillatory ventilation (HFOV) for weaning from total liquid ventilation (TLV). Sixteen lambs were anesthetized. After 1 h of TLV with perflubron (PFOB), they were assigned to either GV or HFOV for 2 h. Oxygen requirements, electrical impedance tomography and videofluoroscopic sequences, and respiratory system compliance were recorded. The lambs under GV needed less oxygen at 20 min following TLV (40 [25, 45] and 83 [63, 98]%, p = 0.001 under GV and HFOV, respectively). During weaning, tidal volume distribution was increased in the nondependent regions in the GV group compared to baseline (p = 0.046). Furthermore, residual PFOB was observed in the most dependent region. No air was detected by fluoroscopy in that region at the end of expiration in the GV group. GV offers a transient advantage over HFOV with regards to oxygenation for TLV weaning.