Comparison of lung protection strategies using conventional and high-frequency oscillatory ventilation.

Abstract

This study compared pathophysiological and biochemical indexes of acute lung injury in a saline-lavaged rabbit model with different ventilatory strategies: a control group consisting of moderate tidal volume (V(T)) (10-12 ml/kg) and low positive end-expiratory pressure (PEEP) (4-5 cmH(2)O); and three protective groups: 1) low V(T) (5-6 ml/kg) high PEEP, 2-3 cmH(2)O greater than the lower inflection point; 2) low V(T) (5-6 ml/kg), high PEEP (8-10 cmH(2)O); and 3) high-frequency oscillatory ventilation (HFOV). The strategy using PEEP > inflection point resulted in hypotension and barotrauma. HFOV attenuated the decrease in pulmonary compliance, the lung inflammation assessed by polymorphonuclear leukocyte infiltration and tumor necrosis factor-alpha concentration in the alveolar space, and pathological changes of the small airways and alveoli. Conventional mechanical ventilation using lung protection strategies (low V(T) high PEEP) only attenuated the decrease in oxygenation and pulmonary compliance. Therefore, HFOV may be a preferable option as a lung protection strategy.

• Authors: Y Imai, S Nakagawa, Y Ito, T Kawano, A S Slutsky, K Miyasaka
• Journal: Journal of applied physiology (Bethesda, Md. : 1985) (J Appl Physiol (1985)) Vol. 91 Issue 4 Pg. 1836-44 (Oct 2001) ISSN: 8750-7587 [Print] United States
• PMID: 11568170 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Tumor Necrosis Factor-alpha

Topics

• Animals
• Bronchoalveolar Lavage
• Bronchoalveolar Lavage Fluid (cytology)
• High-Frequency Ventilation
• Lung (cytology, physiology)
• Lung Compliance (physiology)
• Male
• Neutrophils (physiology)
• Positive-Pressure Respiration
• Pulmonary Alveoli (pathology)
• Pulmonary Gas Exchange (physiology)
• Rabbits
• Respiratory Function Tests
• Tumor Necrosis Factor-alpha (physiology)