 Trials have found that the use of lower tidal volumes 6 mlkg during conventional mechanical ventilation decreases morbidity and mortality. Compared to conventional ventilation, high frequency oscillation HFO is able to provide much smaller tidal volumes 1.1 - 2.5 mlkg and thus theoretically may provide additional lung protection. At this time, while trials of HFO in adults have been inconclusive, the use of HFO for the management of ALIARDS has become widespread 