Non-Conventional Respiratory Support Modalities Applicable in the Older Child

Kallas, Harry J.

doi:10.1016/s0749-0704(05)70025-7

Cited by 9 publications

(3 citation statements)

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“…Furthermore, when a PEEP of 10 cmH 2 O was applied, both Group CMV and Group HFJV had clear drops in blood pressure, indicating that greater amounts of PEEP were decreasing blood pressure even more. In addition, HFV is known to cause less intrathoracic pressure changes than CMV, which should maintain hemodynamic stability [20]. However, we could not identify such an effect in our study, and Group HFJV actually had a lower blood pressure than Group CMV.…”

Section: Discussionmentioning

confidence: 56%

“…HFV is known as an effective approach to ALI, because the immune response to lung injury is altered when pressure changes are small and when hemodynamic stability is maintained [19]. However, there are potential complications with the use of HFV, such as airway damage, necrotic bronchitis, mucous retention, air trapping, air leakage, hemodynamic instability from high airway pressure application, and the hemorrhage of cerebral ventricles in neonates [20]. …”

Section: Discussionmentioning

confidence: 99%

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The effect of positive-end expiratory pressure on oxygenation during high frequency jet ventilation and conventional mechanical ventilation in the rabbit model of acute lung injury

Bang

Choi

2012

Korean J Anesthesiol

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BackgroundThe use of positive end expiratory pressure (PEEP) in patients with acute lung injury (ALI) improves arterial oxygenation by alleviating pulmonary shunting, helping the respiratory muscles to decrease the work of breathing, decreasing the rate of infiltrated and atelectatic tissues, and increasing functional residual capacity. In a rabbit model of saline lavage-induced ALI, we examined the effects of PEEP on gas exchange, hemodynamics, and oxygenation during high frequency jet ventilation (HFJV), and then compared these parameters with those during conventional mechanical ventilation (CMV).MethodsTwelve rabbits underwent repeated saline lavage to create ALI. The animals were divided in 2 groups: 1) Group CMV (n = 6), and 2) Group HFJV (n = 6). In both groups, we applied 2 levels of PEEP (5 cmH2O and 10 cmH2O) and then measured the arterial blood gas, mixed venous blood gas, and hemodynamic parameters.ResultsWith administration of PEEP of either 5 cmH2O or 10 cmH2O, the arterial oxygen content of both groups was increased, although without statistically significant differences between groups. On the contrary, the arterial carbon dioxide content was significantly decreased in the HFJV group, as compared with the CMV group, during the entire experiment. Furthermore, there was significant decreases in mean arterial pressures in both groups with a PEEP of 10 cmH2O.ConclusionsThe application of PEEP in rabbits with ALI effectively improves oxygenation in either HFJV or CMV.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

The effect of positive-end expiratory pressure on oxygenation during high frequency jet ventilation and conventional mechanical ventilation in the rabbit model of acute lung injury

Bang

Choi

2012

Korean J Anesthesiol

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“…8,9) 최근 새로운 환기 방법의 일종으로 perfluorocarbon (PFC)을 이용한 액체환기법이 급성호흡부전의 유용한 치료 방법으로 대두되고 있다. 10,11) 액체환기법은 1991년 Fuhrman 등에 호전과 염증 반응을 감소시켜준다고 보고되고 있다. 8,[13][14][15] 특히 신생아에서 공기누출 폐질환(pulmonary airleak) 특히 폐간질기종이나 기관지흉막루와 같은 경우 CMV에 비해 더 유용하다.…”

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The Effect of High Frequency Jet Ventilation with Partial Liquid Ventilation in Saline Lavaged Lung Injury in the Rabbit

Huh

Choi

2004

Korean J Anesthesiol

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Background: Morbidity and mortality rates from acute respiratory failure remain noteworthy despite advances in conventional ventilatory techniques and improvements in supportive care. Repeated, the large tidal volume breaths during positive pressure mechanical ventilation lead to destruction of alveoli and pulmonary capillaries. Moreover, the overdistention of terminal lung units is considered as an important mechanism of ventilator induced lung injury. High frequency ventilation (HFV) is a technique involving a small tidal volume, and a higher than physiologic respiratory rate. Partial liquid ventilation (PLV), also known as perfluorocarbon-associated gas exchange, is a new technique for respiratory support. This study was designed to compare conventional mechanical ventilation (CMV) and high frequency jet ventilation (HFJV), in combination with PLV.Methods: Twenty rabbits were anesthetized with xylazine, ketamine and vecuronium. We studied rabbits with lung injury induced by saline lavage. Animal were randomized into one of two treatment groups. Ventilator parameters included the following; CMV: FIO2 of 1.0, respiratory rate 20-30 breaths/min, I/E ratio 1：1; HFJV: respiratory rate 2 Hz, driving pressure 2psi. Animals were briefly disconnected from the ventilator and lungs were lavaged with warmed saline. This procedure was repeated until PaO2 ＜ 100 mmHg. After one hour, we initiated the instillation of perfluorodecalin via an endotracheal tube. Baseline measurements were performed at 60 mins after the induction of anesthesia and repeated again at hour after the induction of lung injury, which included 30 mins of stabilization. After PFD instillation, data were recorded.Results: All animals developed hypoxemia after the lung injury, but oxygenation improved significantly after perfluorodecalin instillation. The PLV-HFJV group showed a high pH and a low PaCO2. Mean arterial pressure, cardiac index and systemic vascular resistance was differed significantly. Although there were no qualitative histological differences between lungs ventilated with HFJV on CMV, the lower lobes of all PLV-treated animals were damaged less than the upper lobes, but without statical significance.Conclusions: PLV-HFJV produced a more efficient gas exchange than PLV-CMV. No significant difference was observed in the pulmonary pathologies of the groups.

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