title: A comparison of high-frequency jet ventilation and synchronised intermittent mandatory ventilation in preterm lambs.
abstract: OBJECTIVE
  Synchronised intermittent mandatory ventilation (SIMV) and high-frequency jet ventilation (HFJV) are accepted ventilatory strategies for treatment of respiratory distress syndrome (RDS) in preterm babies. We hypothesised that SIMV and HFJV both facilitate adequate oxygenation and ventilation but that HFJV is associated with less lung injury.
  
  
  RESULTS
  There were no differences in arterial oxygenation or partial pressure of carbon dioxide despite lower mean airway pressure during SIMV for most of the study. There were no consistent significant differences in end systolic and end diastolic PBF, lung injury data and static lung compliance.
  
  
  METHODS
  Preterm lambs of anaesthetised ewes were instrumented, intubated and delivered by caesarean section after intratracheal suction and instillation of surfactant. Each lamb was managed for 3 hr according to a predetermined algorithm for ventilatory support consistent with open lung ventilation. Pulmonary blood flow (PBF) was measured continuously and pulsatility index was calculated. Ventilatory parameters were recorded and arterial blood gases were measured at intervals. At postmortem, in situ pressure-volume deflation curves were recorded, and bronchoalveolar lavage fluid and lung tissue were obtained to assess inflammation.
  
  
  CONCLUSIONS
  SIMV and HFJV have comparable clinical efficacy and ventilator pressure requirements when applied with a targeted lung volume recruitment strategy.
authors.affiliation: Animal Care Services, Faculty of Medicine Dentistry and Health Sciences, University of Western Australia, Perth, Australia.
authors.forename: Gabrielle C
authors.initials: GC
authors.lastname: Musk
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Australia.
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Polglase
authors.affiliation: Department of Bioengineering, University of Utah, Bunnell Inc, Salt Lake City, Utah.
authors.forename: J Bert
authors.initials: JB
authors.lastname: Bunnell
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Australia.
authors.forename: Ilias
authors.initials: I
authors.lastname: Nitsos
authors.affiliation: Neonatal Research, Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Tingay
authors.affiliation: Centre for Neonatal Research and Education, School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.|School of Anatomy, Physiology and Human Biology, The University of Western Australia, Perth, Australia.
authors.forename: J Jane
authors.initials: JJ
authors.lastname: Pillow
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D006611:High-Frequency Jet Ventilation; D007385:Intermittent Positive-Pressure Ventilation; D008168:Lung / Q000473:pathology; D010100:Oxygen / Q000378:metabolism; D011652:Pulmonary Circulation; D011659:Pulmonary Gas Exchange; D012756:Sheep
chemical_list: D010100:Oxygen
keywords: gas exchange; high-frequency jet ventilation; lung injury; pulmonary blood flow; respiratory distress syndrome