High-Frequency Percussive Ventilation

Lucangelo, Umberto; Gramaticopolo, Silvia; Fontanesi, L.

doi:10.1007/978-88-470-0765-9_16

Cited by 6 publications

(7 citation statements)

References 11 publications

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“…The driver for non-invasive respiratory support was a Percussionaire ventilator (Sand Point, ID). This ventilator allows for a combined low-frequency conventional/high-frequency percussive approach, whereby a conventional pressure-limited, time-cycled breath provided at low background frequency is coupled with an underlying high-frequency pattern of small, percussive pressures that deliver sub-physiological tidal volumes ( 24 ). Thus, both conventional and high-frequency gas exchange principles were configured.…”

Section: Discussionmentioning

confidence: 99%

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High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs

et al. 2013

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BackgroundShort-term high-frequency nasal ventilation (HFNV) of preterm neonates provides acceptable gas exchange compared to endotracheal intubation and intermittent mandatory ventilation (IMV). Whether long-term HFNV will provide acceptable gas exchange is unknown. We hypothesized that HFNV for up to 21d would lead to acceptable gas exchange at lower inspired oxygen (O2) levels and airway pressures compared to intubation and IMV.MethodsPreterm lambs were exposed to antenatal steroids, and treated with perinatal surfactant and postnatal caffeine. Lambs were intubated and resuscitated by IMV. At ~3h of age, half of the lambs were switched to non-invasive HFNV. Support was for 3d or 21d. By design, PaO2 and PaCO2 were not different between groups.ResultsAt 3d (n=5) and 21d (n=4) of HFNV, fractional inspired O2 (FiO2), peak inspiratory pressure, mean airway, intra-tracheal, and positive end-expiratory pressures, oxygenation index, and Alveolar-arterial gradient were significantly lower than matched periods of intubation and IMV. PaO2/FiO2 ratio was significantly higher at 3d and 21d of HFNV compared to matched intubation and IMV. HFNV led to better alveolarization at 3d and 21d.ConclusionLong-term HFNV provides acceptable gas exchange at lower inspired O2 levels and respiratory pressures compared to intubation and IMV.

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Section: Discussionmentioning

confidence: 99%

“…We call this mode high-frequency nasal ventilation (HFNV). The Percussionaire is a flow-regulated, time-cycled ventilator that provides controlled-pressure delivery of low-frequency breathing cycles with a series of high-frequency, sub-physiologic tidal volumes ( 24 ).…”

Section: Methodsmentioning

confidence: 99%

High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs

et al. 2013

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“…The HFPV system uses a sliding venturi device (Phasitron) powered by compressed gas to generate the tidal volumes. The Phasitron serves as both the inspiratory and expiratory valve [6,16]. Non-invasive HFPV enhances secretion clearance and is used to deliver respiratory physiotherapy to patients with cystic fibrosis, neuromuscular disorders, and chronic obstructive pulmonary disease [17,18].…”

Section: Primary Outcomementioning

confidence: 99%

Nasal high-frequency percussive ventilation versus nasal continuous positive airway pressure in term and preterm neonates exhibiting respiratory distress: a randomized controlled trial (TONIPEP; NCT 02030691)

Renesme

Roque

Germain

et al. 2020

Preprint

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Objective. To determine whether the use of nasal, high-frequency percussive ventilation (nHFPV) to manage neonatal respiratory distress decreases the regional cerebral oxygen saturation (rScO2) below that afforded by nasal continuous positive airway pressure (nCPAP). Design. Monocentric, prospective, randomized, monocentric, open-label, non-inferiority crossover trial. Patients. Newborns of gestational age (GA) ≥ 33 weeks exhibiting persistent respiratory distress after 10 min of life (Silverman score ≥ 4). Intervention. nHFPV and nCPAP, in succession and in random order. Main outcome measure. Mean rScO2, as revealed by near-infrared spectroscopy (NIRS) performed over the last 5 min of each ventilation mode. To show that nHFPV was not inferior to nCPAP, our a priori calculations required that the lower boundary of the bilateral 95% confidence interval (CI) of the difference between the mean rScO2 values of each ventilation mode should exceed −5. Results. Forty-nine newborns were randomized and 46 were analyzed. The mean (± standard deviation [SD]) GA and birth weight were 36.4 ± 1.9 weeks and 2,718 ± 497 g. The diagnosis was transient tachypnea in 65% of cases and respiratory distress syndrome in 35%. The mean rScO2 difference during the last 5 min of each ventilation mode (nHFPV minus nCPAP) was −0.7 ± 5.4% (95% CI − 2.25; 0.95). Neither a period effect nor a period-treatment interaction was evident. The mean transcutaneous carbon dioxide values (n = 26) for nCPAP and nHFPV were 7.1 ± 4.8 and 7.9 ± 5.1 kPa, respectively. No harmful or unintentional effect was observed. Conclusion. In our study on newborns of GA ≥ 33 weeks treated for respiratory distress, cerebral oxygenation via nHFPV was not inferior to nCPAP.

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“…In comparison with CMV, HFPV improves oxygen exchange but at lower peak airway pressures than CMV, further reducing lung injury while inducing alveolar recruitment and mobilizing secretions from the lung periphery to the central airways. 9,10 Airway pressure release ventilation has been used in the potential lung donor patients in retrospective case series. 11 The case series reported a significant increase in Pa o 2 , with oxygen challenge of 100% F io 2 .…”

Section: Introductionmentioning

confidence: 99%

Use of High-Frequency Percussive Ventilation to Expand Organ Donor Pool

Benn

Afzal

Worku

et al. 2017

J Intensive Care Med

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A 34-year-old woman was brought in to the emergency department after a motor vehicle accident. She had signs of traumatic head injury with Glasgow Coma Scale score of 3, and her neurological examination was consistent with brain death. She was persistently hypoxic on conventional mechanical ventilation and high-frequency percussive ventilation was initiated. The patient's oxygenation improved and was sustained long enough to provide time for organ procurement. This is the first case portraying high-frequency percussive ventilation as a bridge for donors failing on conventional mechanical ventilation.

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High-Frequency Percussive Ventilation

Cited by 6 publications

References 11 publications

High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs

High-frequency nasal ventilation for 21 d maintains gas exchange with lower respiratory pressures and promotes alveolarization in preterm lambs

Nasal high-frequency percussive ventilation versus nasal continuous positive airway pressure in term and preterm neonates exhibiting respiratory distress: a randomized controlled trial (TONIPEP; NCT 02030691)

Use of High-Frequency Percussive Ventilation to Expand Organ Donor Pool

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