High-Frequency Oscillatory Ventilation Combined with Volume Guarantee in a Neonatal Animal Model of Respiratory Distress Syndrome

Abstract

Objective. To assess volume guarantee (VG) ventilation combined with high-frequency oscillatory ventilation (HFOV) strategy on PaCO2 regulation in an experimental model of neonatal distress syndrome. Methods. Six 2-day-old piglets weighing 2.57 ± 0.26 kg were used for this interventional experimental study. Animals were ventilated during physiologic lung conditions and after depletion of lung surfactant by bronchoalveolar lavage (BAL). The effect of HFOV combined with VG on PaCO2 was evaluated at different high-frequency expired tidal volume (VThf) at constant frequency (f R) and mean airway pressure (mPaw). Fluctuations of the pressure (ΔPhf) around the mPaw and PaCO2 were analyzed before and after lung surfactant depletion. Results. PaCO2 levels were inversely proportional to VThf. In the physiological lung condition, an increase in VThf caused a significant decrease in PaCO2 and an increase in ΔPhf. After BAL, PaCO2 did not change as compared with pre-BAL situation as the VThf remained constant by the ventilator. Conclusions. In this animal model, using HFOV combined with VG, changes in the VThf settings induced significant modifications in PaCO2. After changing the lung condition by depletion of surfactant, PaCO2 remained unchanged, as the VThf setting was maintained constant by modifications in the ΔPhf done by the ventilator.

Impact of Volume Guarantee on High-Frequency Oscillatory Ventilation in Preterm Infants: A Randomized Crossover Clinical Trial

“…The results indicated that changes in the VT hf settings caused significant alterations in PCO 2 during HFOV + VG. In addition, after changing the lung condition by depletion of surfactant, PCO 2 remained unchanged, as the VT hf setting was maintained constant by modifications in the amplitude determined by the ventilator [11]. Similarly, the present study demonstrated more uniform tidal volume delivery during VG ventilation even under conditions of rapidly changing lung compliance in the first hours of life.…”

Effective Tidal Volume for Normocapnia in Very-Low-Birth-Weight Infants Using High-Frequency Oscillatory Ventilation

“…Another study showed that an increase in VT from 2 to 3 mL/kg resulted in a decrease in the pCO 2 level from 60±11 mm Hg to 51±8 mm Hg with concomitant increases in the amplitude and DCO 2 in a newborn piglet model, and the DCO 2 value was 68.4 mL 2 /s. 29 In this study, the correlation between the VT and pCO 2 was also significantly negative.…”

High-frequency oscillatory ventilation with volume guarantee: a single-centre experience

“…In an experimental lung model, Mukerji et al showed that during HFOV-VG, VThf remained stable as the frequency was increased and CO 2 elimination improved 4. Two studies used a piglet model to analyse characteristics of HFOV-VG 14 15. Iscan et al ventilated 20 infants born at <32 weeks gestation with HFOV and HFOV-VG for 2 hours for each mode 9.…”