High Frequency Oscillatory Ventilation Versus Conventional Ventilation in a Newborn Piglet Model with Acute Lung Injury.

BACKGROUND: High frequency oscillatory ventilation (HFOV) is considered a protective strategy for human lungs. This study was designed to define microscopic structural features of lung injury following HFOV with a high lung volume strategy in newborn piglets with acute lung injury. METHODS: After ac...

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Publicado en:Respiratory Care Vol. 58; no. 5; pp. 824 - 831
Autores principales: Wanhai Fu, Xiaofei Qin, Churning You, Qiong Meng, Youwei Zhao, Yu Zhang
Formato: pictorial research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. May2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: High Frequency Oscillatory Ventilation Versus Conventional Ventilation in a Newborn Piglet Model with Acute Lung Injury.
      aug:
        au:
          Wanhai Fu
          Xiaofei Qin
          Churning You
          Qiong Meng
          Youwei Zhao
          Yu Zhang
        affil: Department of Pediatrics, Guangdong Second Provincial People's Hospital, Guangzhou, China.
      sug:
        subj:
          Acute Lung Injury Therapy
          Respiration, Artificial Methods
          Respiration, Artificial Adverse Effects
          Ventilation, High Frequency
          Ventilator-Induced Lung Injury Physiopathology
          Acute Lung Injury Microbiology
          Animal Studies
          Swine
          Random Assignment
          Positive End-Expiratory Pressure
          Descriptive Statistics
          Blood Gas Analysis
          Airway Pressure
          Hemodynamics
          Data Analysis Software
          Analysis of Variance
          Post Hoc Analysis
          T-Tests
      ab: BACKGROUND: High frequency oscillatory ventilation (HFOV) is considered a protective strategy for human lungs. This study was designed to define microscopic structural features of lung injury following HFOV with a high lung volume strategy in newborn piglets with acute lung injury. METHODS: After acute lung injury with saline lavage, newborn piglets were randomly assigned to 5 study groups (6 in each group): control (no mechanical ventilation), conventional mechanical ventilation for 24 hours, conventional ventilation for 48 hours, HFOV for 24 hours, and HFOV for 48 hours. The right upper lung tissue was divided into the gravitation-dependent and gravitation- nondependent regions after the completion of mechanical ventilation. Under light microscopy, the numbers of polymorphonuclear leukocytes (PMNLs), alveolar macrophages, red blood cells, and hyaline membrane/alveolar edema were assessed in all lung tissues. Oxygenation index was continuously monitored. RESULTS: Our results showed that the degree of histopathologic lung damage in the gravitation-dependent region was greater than that in the gravitation-nondependent region. Compared with the control group, PMNLs, red blood cells and hyaline membrane/alveolar edemas were significantly increased and alveolar macrophages were significantly decreased in lung tissues of conventional ventilation and HFOV piglets. In HFOV with high lung volume strategy piglets, lung tissues had significantly fewer PMNLs, red blood cells, and hyaline membrane/alveolar edemas, and oxygenation was improved significantly, compared to those of the conventional ventilation piglets. CONCLUSIONS: Histopathologic lung damage in newborn piglets with lung injury was more severe in the gravitation-dependent region than in the gravitation-nondependent region. HFOV with high lung volume strategy reduced pulmonary PMNL infiltration, hemorrhage, alveolar edema, and hyaline membrane formation with improved oxygenation.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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