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No ran-domized trials have been performed that lookedat the elective use of HFOV compared to CMV.Yet use of HFOV has become ingrained in pedi-atric practice and is used frequently in childrenwith acute respiratory distress syndrome, despitethe lack of evidence to support this (Randolphet al. Because of visual diffi cul-ties, patients typically stop reading and watching televi-sion even before marked dementia has developed (Kroppet al., 1999)

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