Original Research ArticleBecause of improved survival rate of low birth weight infants (LBW), there is increasing need of safe ventilation. Conventional ventilation is associated with ventilation induced lung injury (VILI). High frequency oscillatory ventilation (HFO) reduces VILI as it uses subphysiological tidal volume. Preclinical studies have shown that more effective stabilization of DCO2 can be achieved by combining volume guarantee to high frequency ventilation, as in HFO VG tidal volume can be directly controlled. This study is done to evaluate the clinical applicability of this finding of preclinical studies by analyzing the ventilation parameters and physiological parameters of those newborns who are ventilated on HFO or on HFO VG. In this retrospective study neonates ventilated on HFO or HFO VG in the year 2018 were identified and data collected from medical records. Twelve neonates were included in the study. Six of them received high frequency ventilation and other 6 were ventilated on HFO VG mode. VThf (tidal volume in high frequency) were almost same in both groups (1.94 in HFO and 1.9 in HFO VG). It is found that fluctuations in DCO2 (diffusion coefficient of CO2) was less in HFO VG group (SD 43.44 & 92.58 P value0.015). Also babies on HFO VG had better SpO2 values (95.67, 85.83 p value 0.05) and lesser fluctuations in SpO2 (SD 7.0 & 13.64) indicating better oxygenation and lesser hypoxia in HFO VG group. This pilot study suggests VG combined with HFO reduces fluctuations in DCO2 and SpO2.