Person:
Sánchez Luna, Manuel Ramón

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First Name
Manuel Ramón
Last Name
Sánchez Luna
URI
https://hdl.handle.net/20.500.14352/79227
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Salud Pública y Materno-Infantil
Area
Pediatría
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2019 - 201912020 - 20211
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    Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury
    (Journal of Perinatology, 2019) González Pacheco, Noelia; Sánchez Luna, Manuel Ramón; Chimenti Camacho, Paz; Santos González, Martín; Palau Concejo, Paula; Tendillo Cortijo, Francisco Javier
    The use of volume guarantee (VG) on high-frequency oscillatory ventilation (HFOV) allows to use fixed very low high-frequency tidal volume (VThf), maintaining adequate CO2 removal while potentially reducing the risk of ventilator-induced lung injury. Objective: To demonstrate that the use of very low VThf can be protective compared with standard VThf on HFOV combined with VG in a neonatal animal model. Study design: Experimental study in 2-day-old piglets with induced respiratory distress syndrome ventilated with two different HFOV strategies combined with VG (10 Hz with high VThf versus 20 Hz with very low VThf at similar PaCO2). After 12 h of mechanical ventilation, the pulmonary histologic pattern was analyzed. Results: We found in the 10 Hz group with the higher VThf compared with the 20 Hz and very low VThf group more evident and more severe histological lesions with inflammatory infiltrate within the alveolar wall and alveolar space, as well as large areas of parenchyma consolidation and areas of alveolar hemorrhage in the more severe cases. Conclusion: The use of very low VThf compared with higher VThf at similar CO2 removal reduces lung injury in a neonatal animal model of lung injury after prolonged mechanical ventilation with HFOV combined with VG.
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    High-frequency Ventilation
    (Clinics in Perinatology, 2021) Sánchez Luna, Manuel Ramón; González Pacheco, Noelia; Santos González, Martín; Tendillo Cortijo, Francisco Javier
    High-frequency ventilation (HFV) is an alternative to conventional mechanical ventilation, with theoretic benefits of less risk of ventilator lung injury and more effectivity in washout CO2. Previous clinical studies have not demonstrated advantages of HFV in preterm infants compared with conventional ventilation, so rescue HFV has been used when severe respiratory insufficiency needs aggressive ventilator settings in immature infants. Today it is possible to measure, set directly, and fix tidal volume, which can protect the immature lung from large volumes and fluctuations of the tidal volume. This strategy can be used in preterm infants with respiratory failure needing invasive ventilation.