Comparison of different modes of high-frequency ventilation in surfactant-deficient rabbits

被引:0
|
作者
Simma, B
Luz, G
Trawoger, R
Hormann, C
Klima, G
Kreczy, A
Baum, M
机构
[1] UNIV INNSBRUCK, DEPT ANESTHESIA & INTENS CARE MED, A-6020 INNSBRUCK, AUSTRIA
[2] UNIV INNSBRUCK, DEPT HISTOL & EMBRYOL, A-6020 INNSBRUCK, AUSTRIA
[3] UNIV INNSBRUCK, DEPT PATHOL, A-6020 INNSBRUCK, AUSTRIA
关键词
high-frequency ventilation; oxygenation; lung mechanics; histology; critical opening pressure;
D O I
10.1002/(SICI)1099-0496(199610)22:4<263::AID-PPUL6>3.0.CO;2-N
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Various modes of high-frequency ventilation (HFV) have been developed to avoid the disadvantages of conventional mechanical ventilation. In the present study, we examined the hypothesis that high-frequency oscillation (HFO) is superior to high-frequency positive pressure ventilation (HPPV) and combined high-frequency ventilation (CHFV) in surfactant-deficient rabbits. The aim of the ventilator strategy was to adjust the mean airway pressure to 2 cm above critical opening pressure of the inflation limb of the respiratory system pressure volume (P/V) curve, achieve a normal tidal volume (VT) (5 ml/kg body weight) and apply repeated sustained inflations. We studied the effect of these HFV modes on oxygenation, lung mechanics and lung histology in 15 New Zealand White rabbits during a 6-hour experiment. Statistically, the HFO group demonstrated significantly better oxygenation (P < 0.05), lung mechanics (lung stability index: P < 0.05), and better lung tissue histology compared to the HPPV and CHFV groups. In contrast to the HPPV and CHFV groups, the P/V curves of the HFO group showed significant recovery over the 6-hour period after lavage. The lungs of the HFO-treated group had a more uniform distribution of alveoli and less overdistention than the HPPV group (P < 0.002), and less atelectasis than the CHFV group (P < 0.05). The HFO group had less lung injury than the CHFV groups (P < 0.01) and its lungs contained significantly less water than both other groups (P < 0.05). We conclude that the relationship between mean and end-expiratory pressures impacts strongly on both oxygenation and the progression of injury during HFV at the same mean airway pressures. The HFO group showed less acute lung injury than the other ventilatory groups. (C) 1996 Wiley-Liss, Inc.
引用
收藏
页码:263 / 270
页数:8
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