Ventilation with external high frequency oscillation around a negative baseline increases pulmonary blood flow after the Fontan operation

1992 ◽  
Vol 2 (3) ◽  
pp. 277-280 ◽  
Author(s):  
Daniel J. Penny ◽  
Zamir Hayek ◽  
Peter Rawle ◽  
Michael L. Rigby ◽  
Andrew N. Redington
Keyword(s):  
Blood Flow ◽  
Negative Pressure ◽  
High Frequency ◽  
Pulmonary Blood Flow ◽  
Positive Pressure Ventilation ◽  
Fontan Operation ◽  
Intermittent Positive Pressure Ventilation ◽  
High Frequency Oscillation ◽  
Positive Pressure ◽  
Frequency Oscillation

AbstractIn this prospective study, pulmonary blood flow was measured using transesophageal Doppler echocardiography to assess whether ventilation by means of external high frequency oscillation around a negative pressure baseline can increase pulmonary blood flow, compared to intermittent positive pressure ventilation, in five patients after the Fontan operation. Pulmonary blood flow was measured when patients were ventilated by means of intermittent positive pressure ventilation and again during equivalent negative pressure ventilation using the external oscillatory technique. When compared to that with intermittent positive pressure ventilation, ventilation using external high frequency oscillation increased pulmonary blood flow by 116 ±61.5% (p=0.013). These results show that ventilation using an external oscillatory device with a mean negative chamber pressure may provide hemodynamic advantages in patients requiring assisted ventilation after the Fontan operation.

Effect of high-frequency oscillation on lung lymph flow

1983 ◽  
Vol 55 (5) ◽  
pp. 1373-1378 ◽  
Author(s):  
A. L. Jefferies ◽  
P. Hamilton ◽  
H. M. O'Brodovich
Keyword(s):  
High Frequency ◽  
Intermittent Positive Pressure Ventilation ◽  
Lymph Flow ◽  
High Frequency Oscillation ◽  
Positive Pressure ◽  
Frequency Oscillation ◽  
Lymphatic Function ◽  
Vascular Catheters ◽  
Lung Lymph ◽  
Lung Lymph Flow

We investigated the effect of high-frequency oscillation (HFO) on lung lymphatic function under normal conditions and when lung lymph flow was increased by air microembolization. In six experiments, sheep and goats with chronic lung lymph fistulas and vascular catheters were anesthetized, paralyzed, intubated, and ventilated according to the following protocol: 1) intermittent positive-pressure ventilation (IPPV) for 1 h, 2) HFO with a frequency of 15 Hz and an estimated tidal volume of 1-2 ml/kg for 1-2 h, and 3) IPPV for 0.5 h. Ventilator settings were adjusted to maintain arterial Po2 above 100 Torr and a normal arterial Pco2. Vascular, esophageal, and mean airway pressures were monitored continuously. Lymph flow and cardiac output were recorded every 15 min. With this protocol, there were no changes in pulmonary vascular or esophageal pressures, and lymph flow remained stable throughout the experiment. In an additional five experiments, air microemboli were infused for approximately 30 min during HFO. Left atrial pressure was unchanged and lymph flow tripled. This response was qualitatively and quantitatively similar to that previously reported for unanesthetized spontaneously breathing sheep. We conclude that HFO does not impair lymphatic function under resting conditions and that lymphatics retain their ability to increase water and protein clearance during HFO.

Regional Organ Blood Flow during High-frequency Positive-pressure Ventilation (HFPPV) and Intermittent Positive-pressure Ventilation (IPPV)

1984 ◽  
Vol 61 (4) ◽  
pp. 416-419 ◽  
Author(s):  
Leonid Bunegin ◽  
R. Brian Smith ◽  
Ulf H. Sjostrand ◽  
Maurice S. Albin ◽  
Maciej F. Babinski ◽  
...  
Keyword(s):  
Blood Flow ◽  
High Frequency ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Organ Blood Flow

High-frequency oscillation compared with standard ventilation in pulmonary injury model

1982 ◽  
Vol 52 (3) ◽  
pp. 543-548 ◽  
Author(s):  
W. K. Thompson ◽  
B. E. Marchak ◽  
A. B. Froese ◽  
A. C. Bryan
Keyword(s):  
High Frequency ◽  
Positive Pressure Ventilation ◽  
Arterial Oxygen Tension ◽  
Arterial Oxygen ◽  
High Frequency Oscillation ◽  
Positive Pressure ◽  
Positive End Expiratory Pressure ◽  
Frequency Oscillation ◽  
Arterial Blood ◽  
Airway Pressures

Hemorrhagic pulmonary edema was induced by intra-atrial infusion of 0.04--0.1 ml/kg of oleic acid into six anesthetized dogs. Gas exchange and cardiac outputs were then compared at identical mean airway pressures during randomized ventilation with either a volume-cycled ventilator with positive end-expiratory pressure (conventional positive-pressure ventilation, tidal volume 16--21 ml/kg, frequency 15--20 cycles/min) or a variable volume piston pump operating at 15 Hz (high-frequency oscillation). The fractional inspired oxygen concentration was maintained at 0.5 throughout. During 17 data sets matched for intratracheal mean airway pressures over a range of 7.5--27 cmH2O, measurements of systemic arterial pressure, arterial blood gas tensions, thermodilution cardiac outputs, and pulmonary arterial and capillary wedge pressures were identical (P less than 0.05) during ventilation with conventional positive-pressure ventilation and high-frequency oscillation. With both forms of ventilation, arterial oxygen tension progressively improved as mean airway pressure increased. In a shunt model of acute lung injury we were unable to show significant differences in oxygenation or cardiac output when high-frequency oscillation was compared with conventional positive-pressure ventilation with positive end-expiratory pressure at equivalent mean airway pressures.

scholarly journals The Effects of Negative Pressure External High Frequency Oscillation on Cerebral Blood Flow and Cardiac Output of the Monkey

1987 ◽  
Vol 21 (2) ◽  
pp. 166-169 ◽  
Author(s):  
Keith J Barrington ◽  
C Anthony Ryan ◽  
Abraham Peliowsk ◽  
Michael Nosko ◽  
Neil N Finer
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Cerebral Blood Flow ◽  
Negative Pressure ◽  
High Frequency ◽  
High Frequency Oscillation ◽  
Frequency Oscillation

Simple Device for Producing Continuous Negative Pressure in Infants With IRDS

PEDIATRICS ◽  
1973 ◽  
Vol 52 (1) ◽  
pp. 128-131
Author(s):  
Eduardo Bancalari ◽  
Tilo Gerhardt ◽  
Ellen Monkus
Keyword(s):  
Intensive Care Unit ◽  
Negative Pressure ◽  
Positive Pressure Ventilation ◽  
Newborn Infants ◽  
Transpulmonary Pressure ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
School Of Medicine ◽  
Newborn Intensive Care Unit ◽  
Newborn Intensive Care

Increasing experience with the use of continuous transpulmonary pressure, either positive or negative, during the last years has clearly demonstrated the success of this mode of therapy in IRDS.1-3 Forty newborn infants with this disease have been treated with continuous negative pressure (CNP) in the Newborn Intensive Care Unit, Department of Pediatrics, University of Miami School of Medicine, using a modified incubator-respirator.* Twenty-one required only CNP, three of whom died (14%). Among the 19 who needed CNP plus intermittent positive pressure ventilation, nine died (47%). All required more than 70% oxygen to maintain a Pao2 over 50 mm Hg before using CNP.

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