Ventilation by High-Frequency Oscillation in Humans

BUTLER, W. J.; Bohn, Desmond; Bryan, A. C.; Froese, A. B.; virtue, robert

doi:10.1097/00132586-198108000-00032

Cited by 28 publications

(34 citation statements)

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“…High frequency ventilation cannot be explained by apnoeic oxygenation as data of all four groups working in the field of high frequency ventilation (Sjostrand, et all-4, Lunkenheimer, et al, s Butler,et al,6 and ours 7) show gas exchange which cannot be achieved with apnoeic oxygenation,…”

Section: Discussionmentioning

confidence: 62%

“…An electromagnetic vibrator was attached to a tracheal tube and adequate carbon dioxide elimination was found at frequencies between 23 and 40Hz (1380-2400 per minute). Recently Butler, et al 6 described ventilation of four physician volunteers and three patients using oscillations of 15 Hz (900 per minute). Respirators generally used in clinical practice are not capable of operating at high respiratory rates.…”

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confidence: 99%

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Limits of high frequency percutaneous transtracheal jet ventilation using a fluidic logic controlled ventilator

Smith

Klain

Babinski

1980

Canad. Anaesth. Soc. J.

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A study was undertaken on dogs to find the limit of carbon dioxide exchange with high frequency jet ventilation using a fluidic logic controlled oxygen jet ventilator. Fifteen dogs were ventilated through a transtracheal catheter at respiratory rates up to 600 per minute. The following were recorded: aortic, pulmonary artery, pulmonary arterial wedge, and central venous blood pressures; intratraeheal pressure; electrocardiogram; inspiratory and expiratory time of the jet; arterial and central venous blood gases; intermittent cardiac output.Normal gas exchange was found up to a respiratory rate of 400 per minute with low tidal volume and low i ntralracheal pressures. There were no adverse circulatory effects up to a rate of 400 per minute. At rates of 500 and 600 per minute, cardiac contractility was unaffected, but a decreased heart rate and increased peripheral resistance produced a fall in cardiac output. There was no interference with the resumption of spontaneous ventilation during weaning.In a control series of five dogs, apnoeic oxygenation was used. The Pact~ was allowed to reach 15.96 kPa (120 ton-). High frequency jet ventilation was then started at a rate of 600 per minute and decreased in increments to 100 per minute. Arterial blood gases were continuously recorded through an intra-arterial catheter connected to a mass spectrometer. The Pacoz gradually declined to normal levels as the rate decreased.SEVERAL recent Scandinavian papers j-~ describe studies on dogs and man using respiratory rates up to 100 per minute during artificial ventilation. An insufflation catheter was introduced into a standard tracheal tube and good gas exchange was obtained with a small tidal volume. Airway pressure was low and there was little effect on the circulation compared with conventional respiratory rates of 12-20 per minute. With a special connector, the exhalation valve could be adjusted to obtain a positive end expiratory pressure (PEEP) effect.While studying heart performance in dogs, Lunkenheimer, et aIJ observed that transtracheal pressure oscillations improved gas exchange. An electromagnetic vibrator was attached to a tracheal tube and adequate carbon dioxide elimination was found at frequencies between 23 and 40Hz (1380-2400 per minute). Recently Butler, et al. 6 described ventilation of four physician volunteers and three patients using oscillations of 15 Hz (900 per minute). Canad. Anaesth. Soc. J., vol. 27, no. 4, July 1980 Respirators generally used in clinical practice are not capable of operating at high respiratory rates. In our previous work with transtracheal ventilation, 7-~~ we designed a fluidic logic controlled oxygen jet ventilator for this technique.tl This ventilator has rio moving parts and is capable of operating at respiratory rates up to 800 per minute. Our experimental results using ventilating rates up to 200 per minute in dogs with this ventilator, lz as well as clinical results during short laryngeal procedures, ~3 and in patients with respiratory failure ~4 have recently bee...

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Section: Discussionmentioning

confidence: 62%

mentioning

confidence: 99%

Limits of high frequency percutaneous transtracheal jet ventilation using a fluidic logic controlled ventilator

Smith

Klain

Babinski

1980

Canad. Anaesth. Soc. J.

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“…These tidal volumes, although small, may contribute to gas exchange through direct bulk alveolar ventilation. The high-frequency oscillations observed during HAB-CPAP135 may also retain the benefits of HFOV that have been attributed to enhanced gas diffusion and lung recruitment with tidal volumes at or below the anatomic dead space (17).…”

Section: Discussionmentioning

confidence: 98%

Noninvasive Respiratory Support of Juvenile Rabbits by High-Amplitude Bubble Continuous Positive Airway Pressure

et al. 2010

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Bubble continuous positive airway pressure (B-CPAP) applies small-amplitude, high-frequency oscillations in airway pressure (⌬P aw ) that may improve gas exchange in infants with respiratory disease. We developed a device, high-amplitude B-CPAP (HAB-CPAP), which provides greater ⌬P aw than B-CPAP provides. We studied the effects of different operational parameters on ⌬P aw and volumes of gas delivered to a mechanical infant lung model. In vivo studies tested the hypothesis that HAB-CPAP provides noninvasive respiratory support greater than that provided by B-CPAP. Lavaged juvenile rabbits were stabilized on ventilator nasal CPAP. The animals were then supported at the same mean airway pressure, bias flow, and fraction of inspired oxygen (F i O 2 ) required for stabilization, whereas the bubbler angle was varied in a randomized crossover design at exit angles, relative to vertical, of 0 (HAB-CPAP0; equivalent to conventional B-CPAP), 90 (HAB-CPAP90), and 135°(HAB-CPAP135). Arterial blood gases and pressure-rate product (PRP) were measured after 15 min at each bubbler angle. PaO 2 levels were higher (p Ͻ 0.007) with HAB-CPAP135 than with conventional B-CPAP. PaCO 2 levels did not differ (p ϭ 0.073) among the three bubbler configurations. PRP with HAB-CPAP135 were half of the PRP with HAB-CPAP0 or HAB-CPAP90 (p ϭ 0.001). These results indicate that HAB-CPAP135 provides greater respiratory support than conventional B-CPAP does. (Pediatr Res 67: 624-629, 2010) B ubble-nasal continuous positive airway pressure (BnCPAP) is a form of noninvasive respiratory support that is used frequently as a primary strategy for supporting spontaneously breathing preterm infants at risk of developing respiratory distress syndrome. Compared with intubation and mechanical ventilation, the use of B-CPAP has been associated with lower indicators of acute lung injury (1) and bronchopulmonary dysplasia (2).Recent studies suggest that the bubbling of gas exiting the B-nCPAP circuit at the water seal creates oscillations in airway pressure (⌬P aw ), having broadband high frequencies (3), which may promote airway patency and enhance lung volume and gas exchange in preterm lambs (4). However, a study of 261 consecutively born premature infants revealed that 24% of infants born weighing Ͻ1250 g and 50% of infants weighing Ͻ750 g failed B-nCPAP and required endotracheal intubation and mechanical ventilation (5). In an effort to diminish the potentially deleterious effects of invasive mechanical ventilation (6), we designed a novel device, highamplitude B-CPAP (HAB-CPAP), which, through alterations in angle of gas entry at the water seal, may enhance respiratory efficiency and improve oxygenation when compared with conventional B-nCPAP.In this report, we describe a device that provides ⌬P aw higher in amplitude than B-CPAP. Studies were conducted to determine the effects of bubbler angle and bias flow on ⌬P aw and the amplitude of oscillations in volume (⌬V) delivered to a mechanical model of an infant lung. In addition, studies were con...

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“…During the alert awake state respiration cannot be inhibited, although V some subjects can achieve very impressive breathholding times. 54 In chronically tracheostomised dogs, trained to sleep in the laboratory during HFV, as soon as they become drowsy they become apnoeic or the respiratory rate is exceedingly slow and this continues throughout all NREM sleep, s5 However, when they enter REM sleep, hlegular respiration starts interspersed with periods of apnoea, probably reflecting periods of phasic and tonic REM sleep. This escape from inhibition probably has three roots.…”

Section: Control Of Breathingmentioning

confidence: 99%

A review of high-frequency oscillation

Kolton

1984

Can Anaesth Soc J

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Ventilation by High-Frequency Oscillation in Humans

Cited by 28 publications

References 0 publications

Limits of high frequency percutaneous transtracheal jet ventilation using a fluidic logic controlled ventilator

Limits of high frequency percutaneous transtracheal jet ventilation using a fluidic logic controlled ventilator

Noninvasive Respiratory Support of Juvenile Rabbits by High-Amplitude Bubble Continuous Positive Airway Pressure

A review of high-frequency oscillation

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