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Determinants of tidal volume during high-frequency oscillation*

 

作者: Khaled Sedeek,   Muneyuki Takeuchi,   Klaudiusz Suchodolski,   Robert Kacmarek,  

 

期刊: Critical Care Medicine  (OVID Available online 2003)
卷期: Volume 31, issue 1  

页码: 227-231

 

ISSN:0090-3493

 

年代: 2003

 

出版商: OVID

 

关键词: high-frequency oscillation;tidal volume;frequency;inspiratory to expiratory ratio;lung injury;acute respiratory distress syndrome

 

数据来源: OVID

 

摘要:

ObjectiveHigh-frequency oscillation has been proposed for use in adult acute respiratory distress syndrome. However, limited data are available on the effect of pressure amplitude and rate (Hz) on tidal volumes delivered during high-frequency oscillation in adults.DesignProspective, animal model, lung injury study.SettingLarge-animal laboratory of a university-affiliated medical center.SubjectsNine sheep (29.2 ± 2.4 kg).InterventionsSevere lung injury was induced by repeated saline lung lavage. After stabilization, high-frequency oscillation was initiated at a mean airway pressure equal to the point of maximum curvature on the deflation limb of the pressure-volume curve (26 ± 1.9 cm H2O). Tidal volume at all combinations of rates of 4, 6, 8, and 10 Hz, pressure amplitudes of 30, 40, 50, and 60 cm H2O, and inspiratory/expiratory ratios of 1:1 and 1:2 (using the Sensormedics 3100B oscillator) were measured. Flow was measured by a pneumotachometer, amplified and digitized at 1000 Hz. Three breaths were analyzed at each setting.Measurements and Main ResultsAt both inspiratory/expiratory ratios, tidal volume was directly proportional to pressure amplitude and inversely proportional to frequency. During an inspiratory/expiratory ratio of 1:1, at 60 cm H2O pressure amplitude and 4 Hz, a tidal volume of 129.1 ± 34.8 mL (4.4 ± 1.2 mL/kg) was delivered.ConclusionsAt low rates and high-pressure amplitudes in this model, tidal volumes approaching conventional mechanical ventilation can be delivered during high-frequency oscillation.

 

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