RT Journal Article
T1 New indicators for optimal lung recruitment during high frequency oscillator ventilation
A1 Rodríguez Sánchez de la Blanca, Ana
A1 Sánchez Luna, Manuel Ramón
A1 González Pacheco, Noelia
A1 Ramos Navarro, Cristina
A1 Santos González, Martín
A1 Tendillo Cortijo, Francisco Javier
AB Previous research has demonstrated the potential benefit derived from the combination of high frequency oscillatory ventilation and volume guarantee mode (HFOV-VG), a procedure that allows us to explore and control very low tidal volumes. We hypothesized that secondary spontaneous change in oscillation pressure amplitude (∆Phf), while increasing the mean airway pressure (MAP) using HFOV-VG can target the lung recruitment.Methods: A two-step animal distress model study was designed; in the first-step (ex vivo model), the animal's lungs were isolated to visually check lung recruitment and, in the second one (in vivo model), they were checked through arterial oxygen partial pressure improvement. Baseline measurements were performed, ventilation was set for 10 min and followed by bronchoalveolar lavage with isotonic saline to induce depletion of surfactant and thereby achieve a low compliance lung model. The high-frequency tidal volume and frequency remained constant and the MAP was increased by 2 cmH2 O (ex vivo) and 3 cmH2 O steps (in vivo) every 2 min. Changes in ΔPhf to achieve the fixed volume were recorded at the end of each interval to describe the maximum drop point as the recruitment point.Results: Fourteen Wistar Han rats were included, seven on each sub-study described. After gradual MAP increments, a progressive decrease in ΔPhf related to recruited lung regions was visually demonstrated. In the in vivo model we detected a significant comparative decrease of ΔPhf, when measured against the previous value, after reaching a MAP of 11 cmH2 O up to 17 cmH2 O, correlating with a significant improvement in oxygenation.Conclusion: The changes in ∆Phf, linked to a progressive increase in MAP during HFOV-VG, might identify optimal lung recruitment and could potentially be used as an additional lung recruitment marker.
PB Wiley
SN 8755-6863
SN 1099-0496
YR 2020
FD 2020-10
LK https://hdl.handle.net/20.500.14352/99307
UL https://hdl.handle.net/20.500.14352/99307
LA eng
NO Rodríguez Sánchez de la Blanca A,Sánchez Luna M, González Pacheco N, Ramos Navarro C,Santos González M, Tendillo Cortijo F. New indicators foroptimal lung recruitment during high frequency oscillatorventilation.Pediatric Pulmonology. 2020;55:3525‐3531.https://doi.org/10.1002/ppul.25084RODRÍGUEZ SÁNCHEZ DE LA BLANCAET AL.|3531 10990496, 2020, 12, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ppul.25084 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [06/02/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
NO Instituto de Salud Carlos III
DS Docta Complutense
RD 17 abr 2025