J Alexander1, A D Milner. 1. Department of Paediatrics, St. Thomas's Hospital, London, UK.
Abstract
OBJECTIVE: To determine the effect of frequency and percent inspiratory time on tidal volume and gas-trapping during high-frequency oscillatory ventilation (HFOV). SUBJECTS: Nine preterm infants with respiratory distress syndrome tested in the first 48 h of life. METHODS: Tidal volumes and the presence of gas-trapping were measured by respiratory jacket plethysmography at frequencies of 10, 14, and 17.8 Hz and at inspiratory times of 30%, 50% and 70%, using a commercially available high frequency oscillator.74 RESULTS: Mean (SD) tidal volumes were 2.40 (1.06) ml/kg at 10 Hz, 2.52 (1.07) ml/kg at 14 Hz and fell significantly to 1.96 (0.92) at 17.8 Hz (p < 0.05). Tidal volumes at 50% inspiratory time were significantly greater than at 30% inspiratory time [2.81 (1.42) ml/kg and 2.32 (1.18) ml/kg, respectively] but fell to baseline levels at 70% inspiratory time. There was no significant gas-trapping with increases in either frequency or percent inspiratory time. CONCLUSIONS: Gas-trapping is not a significant problem during HFOV in premature infants. Changes in tidal volume with increases in frequency and percent inspiratory time are similar to that seen in animal models.
OBJECTIVE: To determine the effect of frequency and percent inspiratory time on tidal volume and gas-trapping during high-frequency oscillatory ventilation (HFOV). SUBJECTS: Nine preterm infants with respiratory distress syndrome tested in the first 48 h of life. METHODS: Tidal volumes and the presence of gas-trapping were measured by respiratory jacket plethysmography at frequencies of 10, 14, and 17.8 Hz and at inspiratory times of 30%, 50% and 70%, using a commercially available high frequency oscillator.74 RESULTS: Mean (SD) tidal volumes were 2.40 (1.06) ml/kg at 10 Hz, 2.52 (1.07) ml/kg at 14 Hz and fell significantly to 1.96 (0.92) at 17.8 Hz (p < 0.05). Tidal volumes at 50% inspiratory time were significantly greater than at 30% inspiratory time [2.81 (1.42) ml/kg and 2.32 (1.18) ml/kg, respectively] but fell to baseline levels at 70% inspiratory time. There was no significant gas-trapping with increases in either frequency or percent inspiratory time. CONCLUSIONS: Gas-trapping is not a significant problem during HFOV in premature infants. Changes in tidal volume with increases in frequency and percent inspiratory time are similar to that seen in animal models.