An adult with ARDS managed with high-frequency oscillatory ventilation and prone position

High frequency oscillatory ventilation and prone positioning in a porcine model of lavage-induced acute lung injury

“…The objective of our study was to evaluate the effects of prone positioning on gas-exchange, hemodynamics and respiratory parameters in HFOV-ventilated pigs with severe lavage induced acute lung injury [ 16 ]. We hypothesized, that during HFOV oxygenation can be improved at a lower P mean with the animals positioned prone than supine.…”

Cardiovascular responses to high-frequency oscillatory ventilation during acute lung injury in sheep

“…Indeed, when we changed from CMV without PEEP, we found decreased CO at higher mean airway pressure settings. The initial mean airway pressure for HFOV has usually been set at 2-5 cm H 2 O higher than that observed during CMV [9][10][11][12][13][14][15]. When compared with the initial mean airway pressure used during HFOV in other experimental and clinical studies, the initial mean airway pressure of 25 cmH 2 O used in the present study was slightly higher than the recommended initial 7.45 ± 0.08 CMV (6 ml·kg −1 ) with PEEP (before HFOV) 99.6 ± 1.9 54.8 ± 5.6 7.17 ± 0.07 HFOV (mean airway pressure/stroke volume) 25 cmH 2 O/150 ml 159.2 ± 38.5* 26.0 ± 3.3* ; ** 7.46 ± 0.08* ; ** 18 cmH 2 O/150 ml 232.6 ± 97.9* 22.9 ± 4.6* ; ** 7.53 ± 0.14* ; ** 12 cmH 2 O/150 ml 85.9 ± 5.9 24.9 ± 8.3* ; ** 7.53 ± 0.2* ; ** CMV (6 ml·kg −1 ) with PEEP (after HFOV)…”

“…HFO ventilation (HFOV) has been demonstrated to have benefi ts over conventional mechanical ventilation (CMV) in neonatal models of ALI [7], and in neonatal patient populations [8]. Despite disappointing results for HFOV in early clinical trials in adults with ARDS [9][10][11], there is renewed interest in the application of HFOV in adults with ALI [5,[12][13][14][15], because of the increasing evidence of the usefulness of the open-lung strategy in the management of ARDS, as described above.…”

Evaluation of performance of two high-frequency oscillatory ventilators using a model lung with a position sensor

“…In HFOV, lungs are inflated with a tidal volume (V T ) less than anatomic deadspace and at a high respiratory rate (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) [1]. The advantage of HFOV is that, with the maintenance of high mean airway pressure (PEEP), it can ventilate patients without raising peak alveolar pressure.…”