Document Detail

Oxygenation index, an indicator of optimal distending pressure during high-frequency oscillatory ventilation?
MedLine Citation:
PMID:  12185440     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the hypothesis that, during high-frequency oscillatory ventilation (HFOV) of pigs with acute lung injury, the oxygenation index (OI = Paw*FIO(2)*100/PaO(2)) is minimal at the lowest continuous distending pressure (Paw), where the physiological shunt fraction is below 0.1 (Paw(optimal)). DESIGN AND SETTING: Prospective, observational study in a university research laboratory. SUBJECTS: Eight Yorkshire pigs weighing 12.0+/-0.5 kg, with lung injury induced by lung lavage. INTERVENTIONS: After initiation of HFOV, the pigs were subjected to a stepwise increase of Paw to obtain under-inflation, optimal inflation and over-distension of the lungs (inflation) in series, followed by a similar decrease of Paw (deflation). MEASUREMENTS AND RESULTS: At each Paw level, the OI and physiological shunt fraction were determined. The OI reached a minimum of 6.2+/-1.4 at Paw 30+/-4 cmH(2)O during inflation and a minimum of 2.4+/-0.3 at Paw 13+/-2 cmH(2)O during deflation. Paw(optimal) was 32+/-6 cmH(2)O on the inflation limb and 14+/-2 cmH(2)O on the deflation limb. The difference between the Paw at minimal OI and Paw(optimal) was -1.9+/-4.2 cmH(2)O (NS) during inflation and -1.5+/-1.6 cmH(2)O (p<0.05) during deflation. In 15 out of the 16 comparisons, the difference in Paw was within one step (+/-3 cmH(2)O). CONCLUSION: The minimal OI is indicative for the Paw where oxygenation is optimal during HFOV in surfactant-depleted pigs.
Huibert R van Genderingen; Johannus A van Vught; Jos R C Jansen; Elisabeth L I M Duval; Dick G Markhorst; Adrian Versprille
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2002-06-20
Journal Detail:
Title:  Intensive care medicine     Volume:  28     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-19     Completed Date:  2002-12-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1151-6     Citation Subset:  IM    
Department of Clinical Physics & Informatics, Vrije Universiteit Medical Center, PO Box 7057,1007 MB Amsterdam, The Netherlands.
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MeSH Terms
High-Frequency Ventilation*
Oxygen / supply & distribution*
Prospective Studies
Respiratory Distress Syndrome, Adult
Reg. No./Substance:

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