High frequency oscillatory ventilation near resonant frequency of the respiratory system in rabbits with normal and surfactant depleted lungs.
It has been suggested that high frequency oscillatory ventilation (HFV) might improve gas exchange and reduce the risk of pressure-related side-effects compared to conventional mechanical ventilation (CMV). Whereas most studies have used arbitrarily set frequencies for HFV, we evaluated the effects of HFV near resonant frequency (fr). Anaesthetised and tracheotomized adult rabbits (n = 10; 3.8-5.1 kg body weight) were ventilated by alternating periods of CMV and HFV near fr. Negative ventilator resistance was used for complete resistive unloading of the respiratory system before each HFV period. This enabled a continuous swinging at resonance thus allowing measurement of fr and selection of exactly that frequency for the HFV run. Intra-animal CMV-HFV comparisons (n = 4) were performed on each animal: with healthy lungs at a mean airway pressure (MAP) of 0.5 kPa and after saline lung lavage at MAPs of less than 1.5 kPa; 1.5-1.8 kPa; greater than 1.8 kPa. Surfactant removal caused total respiratory system compliance (Ctot) to decrease from 44 +/- 5 to 22 +/- 3 ml/kPa. Corresponding fr was 244 +/- 48 and 360 +/- 30 min-1, respectively. HFV produced effective pulmonary gas exchange but did not improve arterial oxygenation in comparison with CMV at matched MAPs both before and after surfactant depletion. Volume amplitudes of oscillation necessary to achieve normocapnia were slightly above the natural plus equipment (2 ml) dead space. Maximum intra-alveolar pressure (Pmax) was calculated for the HFV runs from MAP, Ctot, and the volume amplitude of oscillation. Pmax during CMV was nearly twice that during HFV at equivalent PaCO2 and equivalent MAPs throughout the experiments.
Schulze
A
A
Children's Hospital, Department of Neonatology, Medical Academy Carl Gustav Carus, Dresden, Federal Republic of Germany.
Schaller
P
P
Dinger
J
J
Winkler
U
U
Gmyrek
D
D
D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D006612:High-Frequency Ventilation / Q000379:methods*; D016018:Least-Squares Analysis; D008168:Lung / Q000737:chemistry / Q000502:physiology*; D008170:Lung Compliance; D010100:Oxygen / Q000097:blood; D011312:Pressure; D011659:Pulmonary Gas Exchange; D011663:Pulmonary Surfactants / Q000172:deficiency*; D011817:Rabbits; D012121:Respiration, Artificial
D011663:Pulmonary Surfactants; D002245:Carbon Dioxide; D010100:Oxygen