OBJECTIVE: High-frequency oscillatory ventilation (HFOV) may reduce ventilator-induced lung injury in experimental neonatal respiratory distress. However, these data permit no conclusions for large animals or adult patients with acute respiratory distress syndrome (ARDS), because in neonates higher frequencies and lower amplitudes can be used, resulting in lower tidal volumes (VT) and airway pressures. The aim of this study was to compare gas exchange, lung histopathology and inflammatory cytokine expression during lung-protective pressure-controlled ventilation (PCV) and HFOV in a long-term large-animal model of ARDS. DESIGN: Prospective, randomized, controlled pilot study. SETTING: University animal laboratory. SUBJECTS: Sixteen female pigs (55.3 +/- 3.9 kg). INTERVENTIONS: After induction of ARDS by repeated lavage, the animals were randomly assigned to PCV (VT = 6 ml/kg) and HFOV (6 Hz). After lung injury, a standardised lung recruitment was performed in both groups, and ventilation was continued for 24 h. MEASUREMENTS AND RESULTS: After lung recruitment sustained improvements in the oxygenation index were observed in both groups. The mean airway pressure (mPaw) was significantly lower in the HFOV group during the experiment (p < 0.01). Histologically, lung inflammation was significantly ameliorated in the HFOV group (p < 0.05). The messenger RNA expression of IL-1-beta in lung tissue was significantly lower in the HFOV-treated animals (p < 0.01). CONCLUSIONS: These data suggest that HFOV compared with conventional lung-protective ventilation can reduce lung inflammation in a large-animal 24-h model of ARDS. Furthermore, it was shown that lung recruitment leads to sustained improvements in gas exchange with a significantly lower mPaw when HFOV is used.
OBJECTIVE: High-frequency oscillatory ventilation (HFOV) may reduce ventilator-induced lung injury in experimental neonatal respiratory distress. However, these data permit no conclusions for large animals or adult patients with acute respiratory distress syndrome (ARDS), because in neonates higher frequencies and lower amplitudes can be used, resulting in lower tidal volumes (VT) and airway pressures. The aim of this study was to compare gas exchange, lung histopathology and inflammatory cytokine expression during lung-protective pressure-controlled ventilation (PCV) and HFOV in a long-term large-animal model of ARDS. DESIGN: Prospective, randomized, controlled pilot study. SETTING: University animal laboratory. SUBJECTS: Sixteen female pigs (55.3 +/- 3.9 kg). INTERVENTIONS: After induction of ARDS by repeated lavage, the animals were randomly assigned to PCV (VT = 6 ml/kg) and HFOV (6 Hz). After lung injury, a standardised lung recruitment was performed in both groups, and ventilation was continued for 24 h. MEASUREMENTS AND RESULTS: After lung recruitment sustained improvements in the oxygenation index were observed in both groups. The mean airway pressure (mPaw) was significantly lower in the HFOV group during the experiment (p < 0.01). Histologically, lung inflammation was significantly ameliorated in the HFOV group (p < 0.05). The messenger RNA expression of IL-1-beta in lung tissue was significantly lower in the HFOV-treated animals (p < 0.01). CONCLUSIONS: These data suggest that HFOV compared with conventional lung-protective ventilation can reduce lung inflammation in a large-animal 24-h model of ARDS. Furthermore, it was shown that lung recruitment leads to sustained improvements in gas exchange with a significantly lower mPaw when HFOV is used.
Authors: M B Amato; C S Barbas; D M Medeiros; R B Magaldi; G P Schettino; G Lorenzi-Filho; R A Kairalla; D Deheinzelin; C Munoz; R Oliveira; T Y Takagaki; C R Carvalho Journal: N Engl J Med Date: 1998-02-05 Impact factor: 91.245
Authors: T E Kloot; L Blanch; A Melynne Youngblood; C Weinert; A B Adams; J J Marini; R S Shapiro; A Nahum Journal: Am J Respir Crit Care Med Date: 2000-05 Impact factor: 21.405
Authors: D R Gerstmann; S D Minton; R A Stoddard; K S Meredith; F Monaco; J M Bertrand; O Battisti; J P Langhendries; A Francois; R H Clark Journal: Pediatrics Date: 1996-12 Impact factor: 7.124
Authors: Katharina von der Hardt; Michael Andreas Kandler; Ludger Fink; Ellen Schoof; Jörg Dötsch; Olga Brandenstein; Rainer Maria Bohle; Wolfgang Rascher Journal: Pediatr Res Date: 2003-12-08 Impact factor: 3.756
Authors: M Hallman; T A Merritt; A L Jarvenpaa; B Boynton; F Mannino; L Gluck; T Moore; D Edwards Journal: J Pediatr Date: 1985-06 Impact factor: 4.406
Authors: Anastasia Pellicano; David G Tingay; John F Mills; Stephen Fasulakis; Colin J Morley; Peter A Dargaville Journal: Intensive Care Med Date: 2009-11 Impact factor: 17.440
Authors: David A Turner; David F Adams; Michael A Gentile; Lee Williford; George A Quick; P Brian Smith; Ira M Cheifetz Journal: Pediatr Crit Care Med Date: 2012-03 Impact factor: 3.624
Authors: Eduardo L V Costa; Guido Musch; Tilo Winkler; Tobias Schroeder; R Scott Harris; Hazel A Jones; Jose G Venegas; Marcos F Vidal Melo Journal: Anesthesiology Date: 2010-03 Impact factor: 7.892