High-frequency oscillation compared with standard ventilation in pulmonary injury model.
Hemorrhagic pulmonary edema was induced by intra-atrial infusion of 0.04--0.1 ml/kg of oleic acid into six anesthetized dogs. Gas exchange and cardiac outputs were then compared at identical mean airway pressures during randomized ventilation with either a volume-cycled ventilator with positive end-expiratory pressure (conventional positive-pressure ventilation, tidal volume 16--21 ml/kg, frequency 15--20 cycles/min) or a variable volume piston pump operating at 15 Hz (high-frequency oscillation). The fractional inspired oxygen concentration was maintained at 0.5 throughout. During 17 data sets matched for intratracheal mean airway pressures over a range of 7.5--27 cmH2O, measurements of systemic arterial pressure, arterial blood gas tensions, thermodilution cardiac outputs, and pulmonary arterial and capillary wedge pressures were identical (P less than 0.05) during ventilation with conventional positive-pressure ventilation and high-frequency oscillation. With both forms of ventilation, arterial oxygen tension progressively improved as mean airway pressure increased. In a shunt model of acute lung injury we were unable to show significant differences in oxygenation or cardiac output when high-frequency oscillation was compared with conventional positive-pressure ventilation with positive end-expiratory pressure at equivalent mean airway pressures.
D000818:Animals; D002302:Cardiac Output; D004285:Dogs; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D019301:Oleic Acid; D009829:Oleic Acids; D011175:Positive-Pressure Respiration; D011654:Pulmonary Edema / Q000139:chemically induced / Q000628:therapy*; D012121:Respiration, Artificial; D013990:Tidal Volume
D006454:Hemoglobins; D009829:Oleic Acids; D019301:Oleic Acid