The primary goal for ARDS patients is to preserve an acceptable gas exchange without further injury to the lungs. High-frequency jet ventilation (HFJV) and highfrequency oscillatory ventilation (HFOV) are characterized by rapid delivery of small tidal volumes (V t ) (1-3 ml/kg predicted body weight) at high frequencies (2.5-5 Hz). As such, P mean during jet ventilation is comparable to the pressure level of PEEP in conventional mechanical ventilation due to its minimal V t . Yet, P peak and P mean are markedly reduced with a reduction of tidal hyperinflation and tidal decruitment [8] . Furthermore, oxygen toxicity may be reduced as lower FiO 2 often are required compared with mandatory ventilation [8] . This beneficial effect could be demonstrated in animal models of HFOV. In addition, pulmonary compliance improved, the infiltration of polymorph nuclear leukocytes was reduced, and tumor necrosis factor-α levels attenuated. As a result, injury to alveoli and membranous bronchioles was reduced [9] .