Cardiovascular responses to high-frequency oscillatory ventilation during acute lung injury in sheep

Nakagawa, Rikimaru; Koizumi, Tomonobu; Ono, Koichi; Tsushima, Kenji; Yoshikawa, Sumiko; Kubo, Keishi; Otagiri, Tetutarou

doi:10.1007/s00540-007-0508-z

Cited by 11 publications

(6 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…40 Furthermore, when switching from CMV to HFOV, the hemodynamic responses were dependent on the predefined setting of PEEP during CMV, and on the applied mean airway pressure during HFOV. 41 In our study, CVP and PAWP were higher after recruitment and during the ventilation period compared with baseline in all four groups. groups across all three pulmonary areas, and in the total lung than 3 Hz and CMV.…”

Section: Critical Care Medicinementioning

confidence: 60%

Higher Frequency Ventilation Attenuates Lung Injury during High-frequency Oscillatory Ventilation in Sheep Models of Acute Respiratory Distress Syndrome

et al. 2013

View full text Add to dashboard Cite

Background: High-frequency oscillatory ventilation (HFOV) at higher frequencies minimizes the tidal volume. However, whether increased frequencies during HFOV can reduce ventilator-induced lung injury remains unknown. Methods: After the induction of acute respiratory distress syndrome in the model by repeated lavages, 24 adult sheep were randomly divided into four groups (n = 6): three HFOV groups (3, 6, and 9 Hz) and one conventional mechanical ventilation (CMV) group. Standard lung recruitments were performed in all groups until optimal alveolar recruitment was reached. After lung recruitment, the optimal mean airway pressure or positive end-expiratory pressure was determined with decremental pressure titration, 2 cm H 2 O every 10 min. Animals were ventilated for 4 h. Results: After lung recruitment, sustained improvements in gas exchange and compliance were observed in all groups. Compared with the HFOV-3 Hz and CMV groups, the transpulmonary pressure and tidal volumes were statistically significantly lower in the HFOV-9 Hz group. The lung injury scores and wet/dry weight ratios were significantly reduced in the HFOV-9 Hz group compared with the HFOV-3 Hz and CMV groups. Expression of interleukin-1β and interleukin-6 in the lung tissue, decreased significantly in the HFOV-9 Hz group compared with the HFOV-3 Hz and CMV groups. Malondialdehyde expression and myeloperoxidase activity in lung tissues in the HFOV-9 Hz group decreased significantly, compared with the HFOV-3 Hz and CMV groups. Conclusion: The use of HFOV at 9 Hz minimizes lung stress and tidal volumes, resulting in less lung injury and reduced levels of inflammatory mediators compared with the HFOV-3 Hz and CMV conditions. A CUTE respiratory distress syndrome (ARDS) is the most severe manifestation of acute lung injury caused by various direct and indirect factors. Inflammatory pulmonary edema, severe hypoxemia, and diffuse endothelial and epithelial injury are key characteristics of ARDS, which can often lead to multiple organ failure.1,2 Despite being the most widely used approach to treat ARDS, conventional mechanical ventilation (CMV) can induce ventilatorinduced lung injury (VILI) due to alveolar overdistension and the cyclic collapse/reopening of lung units, eliciting inflammatory responses, and worsening the damage. 3,4 Recently, protective CMV has been shown to decrease lung and systemic inflammatory responses and improve What We Already Know about This Topic• High-frequency oscillatory ventilation provides efficient gas exchange using very high frequencies and low tidal volumes, while maintaining a constant mean airway pressure • The effects of frequency in high-frequency oscillatory ventilation on ventilation-induced lung injury are yet to be evaluated What This Article Tells Us That Is New• This study suggests that high-frequency oscillatory ventilation at higher frequencies minimizes lung stress and tidal volume, resulting in less lung injury and reduced local lung inflammation

show abstract

Section: Critical Care Medicinementioning

confidence: 60%

Higher Frequency Ventilation Attenuates Lung Injury during High-frequency Oscillatory Ventilation in Sheep Models of Acute Respiratory Distress Syndrome

et al. 2013

View full text Add to dashboard Cite

show abstract

“…In conclusion, APRV mitigating ARDS alveolar damage is more obvious compared with CMV and LTV+SI group, which may be relevant to the spontaneous breathing. The displacement of the diaphragm during spontaneous breathing is the largest gravity dependent area, which more facilitates the gravity-dependent alveolars rich blood to develop recruitment ( 12 , 13 ). Increased mean airway pressure, particularly by increasing time spent at pH, can recruit collapsed alveolus without increasing peak pressure.…”

Section: Discussionmentioning

confidence: 99%

Experimental study of airway pressure release ventilation in the treatment of acute respiratory distress syndrome

Han

Pan

et al. 2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Airway pressure release ventilation (APRV) is a ventilator mode which has demonstrated potential benefits in acute respiratory distress syndrome (ARDS) patients. We therefore sought to compare relevant pulmonary data and safety outcomes of this mode to the conventional ventilation and sustained inflation. Canines admitted after intravenous injection of oleic acid requiring mechanical ventilation were randomly divided into 3 groups (n=6), namely conventional ventilation group, low tidal volume ventilation with recruitment group (LTV+SI) and APRV group. The changes of oxygenation, ventilation, airway pressure, inflammatory reaction and hemodynamics at the basic state were observed at 0, 1, 2 and 4 h during the experiment. The levels of PaO2/FiO2 in APRV group were higher than LTV+SI group at 2 and 4 h (P<0.05). In APRV group, the PCO2 levels at 1, 2 and 4 h is much lower than LTV+SI group (P<0.05). Outcome variables showed no differences between APRV, LVT+SI and conventional mechanical ventilation for plateau airway pressure (24±1 vs. 29±3 vs. 25±4), mean arterial pressure (92.9±16.5 vs. 85.8±21.4 vs. 88.7±24.4), cardiac index (4.3±1.7 vs. 3.5±1.9 vs. 3.4±2.1), ERO2 (13.4±10.3 vs. 16.1±6.8 vs. 17.6±9.1), lac (2.5±1.7 vs. 3.1±1.6 vs. 3.9±1.9), tumor necrosis factor (TNF)-α (132±11 vs. 140±6 vs. 195±13) and matrix metalloproteinase (MMP)-9. For canines sustaining acute respiratory distress syndrome requiring mechanical ventilation, APRV can significantly improve oxygenation and keep hemodynamic stability compared with LTV+SI. The results of TNF-α and MMP-9 suggest that APRV could be as protective for ARDS as LTV with recruitment group.

show abstract

“…20,23,24 In addition, HFO with higher MAP setting can decrease venous return of systemic circulation due to overdistention of the alveoli, which may decrease cardiac output and oxygen delivery. 15,20,24,29 The net effects of high MAP and decreased cardiac output may lead to compression of the pulmonary capillaries and increased pulmonary vascular resistance. 29 In the present study, at least, a higher MAP setting during HFO did not reduce systemic artery pressure or increase venous pressure.…”

Section: Journal Of Inflammationmentioning

confidence: 99%

Comparisons of different mean airway pressure settings during high-frequency oscillation in inflammatory response to oleic acid-induced lung injury in rabbits

Koizumi¹

2009

JIR

Self Cite

View full text Add to dashboard Cite

The present study was designed to examine effects of different mean airway pressure (MAP) settings during high-frequency oscillation (HFO) on oxygenation and infl ammatory responses to acute lung injury (ALI) in rabbits. Methods: Anesthetized rabbits were mechanically ventilated with a conventional mechanical ventilation (CMV) mode (tidal volume 6 ml/kg, inspired oxygen fraction [F Io2 ] of 1.0, respiratory rate [RR] of 30/min, positive end-expiratory pressure [PEEP] of 5 cmH 2 O). ALI was induced by intravenous administration of oleic acid (0.08 ml/kg) and the animals were randomly allocated to the following three experimental groups; animals (n = 6) ventilated using the same mode of CMV, or animals ventilated with standard MAP (MAP 10 cmH 2 O, n = 7), and high MAP (15 cmH 2 O, n = 6) settings of HFO (Hz 15). The MAP settings were calculated by the infl ation limb of the pressure-volume curve during CMV. Results: HFO with a high MAP setting signifi cantly improved the deteriorated oxygenation during oleic acid-induced ALI and reduced wet/dry ratios, neutrophil counts and interleukin-8 concentration in bronchoalveolar lavage fl uid, compared to those parameters in CMV and standard MAP-HFO. Conclusions: These fi ndings suggest that only high MAP setting during HFO could contribute to decreased lung infl ammation as well as improved oxygenation during the development of ALI.

show abstract

Cardiovascular responses to high-frequency oscillatory ventilation during acute lung injury in sheep

Abstract: We conclude that hemodynamic responses are dependent on the predefined setting of PEEP during CMV, and on applied mean airway pressure during HFOV.

Cited by 11 publications

References 30 publications

Higher Frequency Ventilation Attenuates Lung Injury during High-frequency Oscillatory Ventilation in Sheep Models of Acute Respiratory Distress Syndrome

Higher Frequency Ventilation Attenuates Lung Injury during High-frequency Oscillatory Ventilation in Sheep Models of Acute Respiratory Distress Syndrome

Experimental study of airway pressure release ventilation in the treatment of acute respiratory distress syndrome

Comparisons of different mean airway pressure settings during high-frequency oscillation in inflammatory response to oleic acid-induced lung injury in rabbits

Contact Info

Product

Resources

About