High Frequency Percussive Ventilation

Lucangelo, Umberto; Fontanesi, L.; Bird, Forrest M.

doi:10.1007/978-88-470-2099-3_14

Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E. 2002

DOI: 10.1007/978-88-470-2099-3_14

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High Frequency Percussive Ventilation

Umberto Lucangelo¹,

L. Fontanesi²,

Forrest M. Bird³

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2022

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Cited by 2 publications

References 19 publications

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High frequency percussive ventilation: An asset to existing ventilation modi in intraoperative care?

Rijckaert¹,

Moerman²,

Vandenheuvel³

2022

Acta Anaest Belg

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High frequency percussive ventilation (HFPV) is a ventilation mode that combines positive pressure ventilation with some advantages of high frequency ventilation. During HFPV, a pulsatile flow is generated with high frequency and low volumes. HFPV has been used in the intensive care unit (ICU) for several decades, in case of insufficient conventional positive pressure ventilation. However, literature on its use in intraoperative care is scarce. We hypothesize that HFPV might be a better alternative to existing ventilation modi during selected operative procedures or in patients with severely compromised pulmonary and/or cardiac function. In this paper, we explain the HFPV system, we zoom in on the physiological effects of HFPV, and we describe its potential role in the intraoperative setting. Results of existing studies show that, compared to other conventional ventilation modes, HFPV improves oxygenation and ventilation without jeopardizing hemodynamics. However, because of the low quality evidence regarding physiological effects and clinical effectiveness, and due to the complicated design and set-up of the HFPV ventilator, the use of HFPV in intraoperative care is currently very limited. We conclude that HFPV could potentially be an interesting ventilation mode for procedures requiring minimal respiratory motion or low airway pressures, however larger (comparative) study trials are required to evaluate its usability in the operating room in patients with compromised pulmonary and/or cardiac function.

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High frequency percussive ventilation: An asset to existing ventilation modi in intraoperative care?

Rijckaert¹,

Moerman²,

Vandenheuvel³

2022

Acta Anaest Belg

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Impact of opioid free Anaesthesia versus opioid Anaesthesia on the immediate postoperative oxygenation after bariatric surgery: a prospective observational study

Geerts¹,

Carvalho²,

Jarahyan³

et al. 2022

Acta Anaest Belg

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Introduction: Opioid induced respiratory depression (OIRD) is a preventable aetiology of postoperative respiratory depression with 85% of the episodes taking place in the first 24 postoperative hours. Due to altered respiratory functional metrics and frequently coexisting comorbidities, obese patients are at a particularly higher risk for such complications. The present study aimed to assess if an opioid-free anesthesia (OFA) was associated with a reduced immediate postoperative OIRD when compared to Opiod-based anesthesia (OA). Methods: Obese patients presenting for bariatric surgery were consecutively included in a non-randomized fashion. Lung protective ventilation strategies applied in both groups. In the OA group, Sufentanil was used for intraoperative analgesia in a liberal fashion. In the OFA group, patients received a pre-induction dexmedetomidine loading, followed by a lidocaine, ketamine and dexmedetomidine bolus immediately before induction, further maintained throughout the intraoperative period. Plethysmographic saturations were obtained before induction as well as after extubation and in the Post-anesthesia care unit (PACU). Opioid requirement and Postoperative Nausea and Vomiting incidence were similarly registered. Results: Thirty-four patients were included in the OFA group, and 30 in the OA group. No significant anthropometric and comorbidity differences were found between both groups. OFA patients had significantly lower pre-induction saturations after dexmedetomidine loading. No difference was found for post-extubation saturations as well as well as pre-PACU discharge. The need for supplemental oxygen at the PACU was higher in the OA group. Opioid requirement and cumulative consumption (MEDs) were significantly higher with OA. Conclusion: OFA was not associated with significant postoperative saturation changes but led to a lower need of postoperative supplemental oxygen therapy. OA led to higher opioid rescue need. No fatal respiratory complications were registered in both groups in the immediate postoperative period.

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High Frequency Percussive Ventilation

Cited by 2 publications

References 19 publications

High frequency percussive ventilation: An asset to existing ventilation modi in intraoperative care?

High frequency percussive ventilation: An asset to existing ventilation modi in intraoperative care?

Impact of opioid free Anaesthesia versus opioid Anaesthesia on the immediate postoperative oxygenation after bariatric surgery: a prospective observational study

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