Document Detail

Deviation of tracheal pressure from airway opening pressure during high-frequency oscillatory ventilation in a porcine lung model.
MedLine Citation:
PMID:  23458472     Owner:  NLM     Status:  Publisher    
ABSTRACT Oxygenation during high-frequency oscillatory ventilation is secured by a high level of mean airway pressure. Our objective was to identify a pressure difference between the airway opening of the respiratory circuit and the trachea during application of different oscillatory frequencies. Six female Pietrain pigs (57.1 ± 3.6 kg) were first ventilated in a conventional mechanical ventilation mode. Subsequently, the animals were switched to high-frequency oscillatory ventilation by setting mean airway opening pressure 5 cmH2O above the one measured during controlled mechanical ventilation. Measurements at the airway opening and at tracheal levels were performed in healthy lungs and after induction of acute lung injury by surfactant depletion. During high-frequency oscillatory ventilation, the airway opening pressure was set at a constant level. The pressure amplitude was fixed at 90 cmH2O. Starting from an oscillatory frequency of 3 Hz, the frequency was increased in steps of 3 Hz to 15 Hz and then decreased accordingly. At each frequency, measurements were performed in the trachea through a side-lumen of the endotracheal tube and the airway opening pressure was recorded. The pressure difference was calculated. At every oscillatory frequency, a pressure loss towards the trachea could be shown. This pressure difference increased with higher oscillatory frequencies (3 Hz 2.2 ± 2.1 cmH2O vs. 15 Hz 7.5 ± 1.8 cmH2O). The results for healthy and injured lungs were similar. Tracheal pressures decreased with higher oscillatory frequencies. This may lead to pulmonary derecruitment. This has to be taken into consideration when increasing oscillatory frequencies and differentiated pressure settings are mandatory.
Amélie Johannes; Bernd Zollhoefer; Ulrike Eujen; Markus Kredel; Stefan Rauch; Norbert Roewer; Ralf M Muellenbach
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-4
Journal Detail:
Title:  Experimental lung research     Volume:  -     ISSN:  1521-0499     ISO Abbreviation:  Exp. Lung Res.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004944     Medline TA:  Exp Lung Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1Department of Anaesthesia and Critical Care, University of Würzburg , Würzburg , Germany.
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