Bringing back the old: time to reevaluate the high-frequency ventilation strategy.

Objective:To examine the role of frequency in high-frequency ventilation (HFV) on carbon-dioxide (CO2) elimination and lung injury, independent of its effect on tidal volume.Study Design:An anatomically representative lung model was attached to a mechanical ventilator capable of providing HFV with a...

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Publicado en:Journal of Perinatology Vol. 34; no. 6; pp. 464 - 468
Autores principales: Mukerji, A, Belik, J, Sanchez-Luna, M
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jun2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2014
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      pub: Springer Nature
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        10.1038/jp.2014.39
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        atl: Bringing back the old: time to reevaluate the high-frequency ventilation strategy.
      aug:
        au:
          Mukerji, A
          Belik, J
          Sanchez-Luna, M
        affil: Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
      sug:
        subj:
          Respiration, Artificial Methods
          Human
          Models, Anatomic
          In Vitro Studies
          Two-Way Analysis of Variance
          Post Hoc Analysis
          Descriptive Statistics
      ab: Objective:To examine the role of frequency in high-frequency ventilation (HFV) on carbon-dioxide (CO2) elimination and lung injury, independent of its effect on tidal volume.Study Design:An anatomically representative lung model was attached to a mechanical ventilator capable of providing HFV with a constant volume. CO2 was infused directly into the lung, and a commercially available end-tidal CO2 detector was used to determine CO2 elimination. CO2 elimination and amplitude of pressure transmissions were evaluated using frequencies ranging from 5 to 15 Hz. The pressure-volume index (PVI) was described as the product of the volume and pressures delivered to the lung, a surrogate for lung injury.Result:The use of increasing frequencies directly correlated with improved CO2 clearance when keeping the tidal volume fixed, expressed as percent CO2 remaining in the lung at 25 s (66.5 (±1.1)%, 50.5 (±0.1)% and 37.8 (±0.3)% at 5, 10 and 15 Hz, respectively, P<0.05). With a fixed tidal volume, there was a decrease in pressure amplitudes transmitted to the lung with a decline in the PVI (53.9 (±2.7) mmHg ml−1, 41.1 (±0.9) mmHg ml−1 and 23.4 (±3.6) mmHg ml−1, at 5, 10 and 15 Hz, respectively, P<0.05).Conclusion:Frequency has a direct relationship with CO2 elimination when tidal volume is fixed. Using low delivered tidal volumes and high frequencies may allow for improved ventilation efficacy, while minimizing lung injury.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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