| Spontaneous breathing during high-frequency oscillatory ventilation improves regional lung characteristics in experimental lung injury. | |
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MedLine Citation:
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PMID: 21039346 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Maintenance of spontaneous breathing is advocated in mechanical ventilation. This study evaluates the effect of spontaneous breathing on regional lung characteristics during high-frequency oscillatory (HFO) ventilation in an animal model of mild lung injury. METHODS: Lung injury was induced by lavage with normal saline in eight pigs (weight range 47-64 kg). HFO ventilation was applied, in runs of 30 min on paralyzed animals or on spontaneous breathing animals with a continuous fresh gas flow (CF) or a custom-made demand flow (DF) system. Electrical impedance tomography (EIT) was used to assess lung aeration and ventilation and the occurrence of hyperinflation. RESULTS: End expiratory lung volume (EELV) decreased in all different HFO modalities. HFO, with spontaneous breathing maintained, showed preservation in lung volume in the dependent lung regions compared with paralyzed conditions. Comparing DF with paralyzed conditions, the center of ventilation was located at 50% and 51% (median, left and right lung) from anterior to posterior and at 45% and 46% respectively, P<0.05. Polynomial coefficients using a continuous flow were -0.02 (range -0.35 to 0.32) and -0.01 (-0.17 to 0.23) for CF and DF, respectively, P=0.01. CONCLUSIONS: This animal study demonstrates that spontaneous breathing during HFO ventilation preserves lung volume, and when combined with DF, improves ventilation of the dependent lung areas. No significant hyperinflation occurred on account of spontaneous breathing. These results underline the importance of maintaining spontaneous breathing during HFO ventilation and support efforts to optimize HFO ventilators to facilitate patients' spontaneous breathing. |
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Authors:
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M van Heerde; K Roubik; V Kopelent; M C J Kneyber; D G Markhorst |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 54 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 1248-56 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Journal compilation © 2010 The Acta Anaesthesiologica Scandinavica Foundation. |
Affiliation:
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Department of Pediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands. m.vanheerde@vumc.nl |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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