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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1016/0294-3506(95)80197-9

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1432-1238

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Highfrequency oscillatory ventilation in experime

Authors: Rolf Dembinski Martin Max Ralf Bensberg Johannes Bickenbach Ralf Kuhlen Rolf Rossaint
Publish Date: 2002/04/19
Volume: 28, Issue: 6, Pages: 768-774
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Abstract

Objective To compare ventilationperfusion VA/Q distributions during improvement of oxygenation caused by highfrequency oscillatory ventilation HFOV and pressurecontrolled mechanical ventilation with high PEEP levels CMV in experimental acute lung injury ALIInterventions Twelve pigs with oleic acidinduced ALI were randomised to HFOV n=6 or to CMV n=6 with a PEEP of 15 mbar for 1 h The mean airway pressure was adjusted in both groups to achieve comparable improvements in arterial oxygen partial pressure PaO2 and to avoid clinically relevant impairments of cardiac output as assured by adequate mixed venous oxygen saturation and lactate levels VA/Q distributions were determined by the multiple inert gas elimination technique MIGETMeasurements and results Arterial oxygen partial pressure improved during CMV with a mean airway pressure of 20 mbar p005 whereas HFOV revealed comparable improvements with a mean airway pressure of 40 mbar p005 Shunt decreased and blood flow to normal VA/Q areas increased due to CMV and HFOV p005 The perfusion of low VA/Q areas remained unchanged Statistical analysis did not reveal differences of PaO2 shunt or blood flow to low VA/Q areas between the groupsConclusions In this model of acute lung injury CMV and HFOV improved gas exchange due to similar changes in VA/Q distribution However mean airway pressure had to be adjusted twofold higher during HFOV then during CMV to achieve comparable improvements in gas exchange

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