Gas transport during high-frequency ventilation

1983 ◽  
Vol 55 (2) ◽  
pp. 472-478 ◽  
Author(s):  
V. Brusasco ◽  
T. J. Knopp ◽  
K. Rehder
Keyword(s):  
Stroke Volume ◽  
Dead Space ◽  
High Frequency ◽  
Oscillation Frequency ◽  
High Frequency Ventilation ◽  
Dead Space Volume ◽  
Entire Lung ◽  
Frequency Ventilation ◽  
Gas Volume ◽  
Space Volume

During high-frequency small-volume ventilation (HFV), the transport rate of gas from the mouth to a lung region is a function of two conductances (conductance is the transfer rate of a gas divided by its partial pressure difference): regional longitudinal gas conductance along the airways (Grlongi) and gas conductance between lung regions (Ginter). Grlongi per unit regional lung (gas) volume [Grlongi/(Vr beta g)] was determined during HFV in 11 anesthetized paralyzed dogs lying supine. The distribution of Grlongi/(Vr beta g) was nearly uniform during HFV when stroke volumes were less than approximately two-thirds of the Fowler dead-space volume. By contrast, the distribution of Grlongi/(Vr beta g) was nonuniform when the stroke volume exceeded approximately two-thirds of the Fowler dead-space volume and the oscillation frequency was 5 Hz. Gas conductance along the airways per unit lung gas volume [average Glongi/(V beta g)], for the entire lung, increased with stroke volume at all frequencies, but for a given product of oscillation frequency and stroke volume, the average Glongi/(V beta g) was greater when stroke volume was large and oscillation frequency was low. The average Glongi/(V beta g) increased with frequency up to a maximal value; the frequency at which the maximum occurred depended on the kinematic viscosity of the inspired gas mixture.

Resonant amplification of delivered volume during high-frequency ventilation

1986 ◽  
Vol 60 (3) ◽  
pp. 885-892 ◽  
Author(s):  
V. Brusasco ◽  
K. C. Beck ◽  
M. Crawford ◽  
K. Rehder
Keyword(s):  
Stroke Volume ◽  
Endotracheal Tube ◽  
High Frequency ◽  
Gas Flow ◽  
High Frequency Ventilation ◽  
Frequency Ventilation ◽  
Anesthetized Dogs ◽  
Gas Volume

The volume of gas delivered from a high-frequency ventilation (HFV) circuit was measured with an ultrasonic flowmeter. The measurements were done in vitro (20-liter air-filled glass bottle) and in vivo (9 anesthetized dogs lying supine) at oscillation frequencies ranging from 4 to 23 Hz and stroke volumes of the pump ranging from 36 to 150 ml. We varied the length and diameter of the tube connecting the pump with the endotracheal tube, the length and diameter of the bias outflow tube, the diameter of the endotracheal tube, and the stroke volume of the pump. Both in vitro and in vivo, there was resonant amplification of the delivered gas volume; i.e., the delivered gas volume exceeded the stroke volume at certain frequencies. Altering the dimensions of connecting tube, endotracheal tube, bias outflow tube, or stroke volume, i.e., changing the resistance to gas flow, gas compliance, and/or gas inertance in these elements, altered the ratio of gas delivered to stroke volume that could be predicted by an electric analog. These data indicate that the delivered gas volume during HFV depends critically on the configuration of the HFV circuit, the size of the endotracheal tube, the oscillation frequency, and the pump stroke volume. Knowledge of the delivered gas volume during HFV and appreciation of the phenomenon of resonant amplification of the delivered gas volume will permit a more accurate description of factors contributing to gas transport during HFV.

High-frequency ventilation

1984 ◽  
Vol 64 (2) ◽  
pp. 505-543 ◽  
Author(s):  
J. M. Drazen ◽  
R. D. Kamm ◽  
A. S. Slutsky
Keyword(s):  
Experimental Data ◽  
Gas Exchange ◽  
Dead Space ◽  
Gas Transport ◽  
Physical Models ◽  
High Frequency Ventilation ◽  
General Description ◽  
Wide Range ◽  
Dead Space Volume ◽  
Space Volume

Complete physiological understanding of HFV requires knowledge of four general classes of information: 1) the distribution of airflow within the lung over a wide range of frequencies and VT (sect. IVA), 2) an understanding of the basic mechanisms whereby the local airflows lead to gas transport (sect. IVB), 3) a computational or theoretical model in which transport mechanisms are cast in such a form that they can be used to predict overall gas transport rates (sect. IVC), and 4) an experimental data base (sect. VI) that can be compared to model predictions. When compared with available experimental data, it becomes clear that none of the proposed models adequately describes all the experimental findings. Although the model of Kamm et al. is the only one capable of simulating the transition from small to large VT (as compared to dead-space volume), it fails to predict the gas transport observed experimentally with VT less than equipment dead space. The Fredberg model is not capable of predicting the observed tendency for VT to be a more important determinant of gas exchange than is frequency. The remaining models predict a greater influence of VT than frequency on gas transport (consistent with experimental observations) but in their current form cannot simulate the additional gas exchange associated with VT in excess of the dead-space volume nor the decreased efficacy of HFV above certain critical frequencies observed in both animals and humans. Thus all of these models are probably inadequate in detail. One important aspect of these various models is that some are based on transport experiments done in appropriately scaled physical models, whereas others are entirely theoretical. The experimental models are probably most useful in the prediction of pulmonary gas transport rates, whereas the physical models are of greater value in identifying the specific transport mechanism(s) responsible for gas exchange. However, both classes require a knowledge of the factors governing the distribution of airflow under the circumstances of study as well as requiring detail about lung anatomy and airway physical properties. Only when such factors are fully understood and incorporated into a general description of gas exchange by HFV will it be possible to predict or explain all experimental or clinical findings.

Physiological dead space during high-frequency ventilation in dogs

1984 ◽  
Vol 57 (3) ◽  
pp. 881-887 ◽  
Author(s):  
G. G. Weinmann ◽  
W. Mitzner ◽  
S. Permutt
Keyword(s):  
Gas Exchange ◽  
Tidal Volume ◽  
Dead Space ◽  
High Frequency ◽  
Minute Ventilation ◽  
Alveolar Ventilation ◽  
High Frequency Ventilation ◽  
Physiological Dead Space ◽  
Frequency Ventilation ◽  
Normal Ventilation

Tidal volumes used in high-frequency ventilation (HFV) may be smaller than anatomic dead space, but since gas exchange does take place, physiological dead space (VD) must be smaller than tidal volume (VT). We quantified changes in VD in three dogs at constant alveolar ventilation using the Bohr equation as VT was varied from 3 to 15 ml/kg and frequency (f) from 0.2 to 8 Hz, ranges that include normal as well as HFV. We found that VD was relatively constant at tidal volumes associated with normal ventilation (7–15 ml/kg) but fell sharply as VT was reduced further to tidal volumes associated with HFV (less than 7 ml/kg). The frequency required to maintain constant alveolar ventilation increased slowly as tidal volume was decreased from 15 to 7 ml/kg but rose sharply with attendant rapid increases in minute ventilation as tidal volumes were decreased to less than 7 ml/kg. At tidal volumes less than 7 ml/kg, the data deviated substantially from the conventional alveolar ventilation equation [f(VT - VD) = constant] but fit well a model derived previously for HFV. This model predicts that gas exchange with volumes smaller than dead space should vary approximately as the product of f and VT2.

High-frequency ventilation and oscillation

2016 ◽  
Author(s):  
Mireia Cuartero ◽  
Niall D. Ferguson
Keyword(s):  
High Frequency ◽  
Rescue Therapy ◽  
Conventional Mechanical Ventilation ◽  
High Frequency Ventilation ◽  
Ventilatory Strategy ◽  
Severe Hypoxaemia ◽  
Dead Space Volume ◽  
Frequency Ventilation ◽  
Ventilation Strategies ◽  
Physiological Values

High-frequency oscillatory ventilation (HFOV) is a key member of the family of modes called high-frequency ventilation and achieves adequate alveolar ventilation despite using very low tidal volumes, often below the dead space volume, at frequencies significantly above normal physiological values. It has been proposed as a potential protective ventilatory strategy, delivering minimal alveolar tidal stretch, while also providing continuous lung recruitment. HFOV has been successfully used in neonatal and paediatric intensive care units over the last 25 years. Since the late 1990s adults with acute respiratory distress syndrome have been treated using HFOV. In adults, several observational studies have shown improved oxygenation in patients with refractory hypoxaemia when HFOV was used as rescue therapy. Several small older trials had also suggested a mortality benefit with HFOV, but two recent randomized control trials in adults with ARDS have shed new light on this area. These trials not show benefit, and in one of them a suggestion of harm was seen with increased mortality for HFOV compared with protective conventional mechanical ventilation strategies (tidal volume target 6 mL/kg with higher positive end-expiratory pressure). While these findings do not necessarily apply to patients with severe hypoxaemia failing conventional ventilation, they increase uncertainty about the role of HFOV even in these patients.

Time and volume dependence of dead space in healthy and surfactant-depleted rat lungs during spontaneous breathing and mechanical ventilation

2013 ◽  
Vol 115 (9) ◽  
pp. 1268-1274 ◽  
Author(s):  
Constanze Dassow ◽  
David Schwenninger ◽  
Hanna Runck ◽  
Josef Guttmann
Keyword(s):  
Mechanical Ventilation ◽  
Tidal Volume ◽  
Dead Space ◽  
Spontaneous Breathing ◽  
Small Animals ◽  
Single Breath ◽  
Dead Space Volume ◽  
The Dead ◽  
Gas Volume ◽  
Space Volume

Volumetric capnography is a standard method to determine pulmonary dead space. Hereby, measured carbon dioxide (CO2) in exhaled gas volume is analyzed using the single-breath diagram for CO2. Unfortunately, most existing CO2 sensors do not work with the low tidal volumes found in small animals. Therefore, in this study, we developed a new mainstream capnograph designed for the utilization in small animals like rats. The sensor was used for determination of dead space volume in healthy and surfactant-depleted rats ( n = 62) during spontaneous breathing (SB) and mechanical ventilation (MV) at three different tidal volumes: 5, 8, and 11 ml/kg. Absolute dead space and wasted ventilation (dead space volume in relation to tidal volume) were determined over a period of 1 h. Dead space increase and reversibility of the increase was investigated during MV with different tidal volumes and during SB. During SB, the dead space volume was 0.21 ± 0.14 ml and increased significantly at MV to 0.39 ± 0.03 ml at a tidal volume of 5 ml/kg and to 0.6 ± 0.08 ml at a tidal volume of 8 and 11 ml/kg. Dead space and wasted ventilation during MV increased with tidal volume. This increase was mostly reversible by switching back to SB. Surfactant depletion had no further influence on the dead space increase during MV, but impaired the reversibility of the dead space increase.

Gas exchange during high-frequency ventilation of the chicken

1982 ◽  
Vol 53 (6) ◽  
pp. 1418-1422 ◽  
Author(s):  
R. B. Banzett ◽  
J. L. Lehr
Keyword(s):  
Gas Exchange ◽  
Tidal Volume ◽  
Dead Space ◽  
High Frequency ◽  
Conventional Mechanical Ventilation ◽  
High Frequency Ventilation ◽  
Tracheal Cannula ◽  
Bias Flow ◽  
Frequency Ventilation ◽  
Co2 Elimination

Recent studies have shown that high-frequency ventilation (HFV) at 1–30 Hz is capable of maintaining adequate gas exchange in humans and dogs even when tidal volumes are substantially less than dead space. We evaluated the effectiveness of HFV in roosters by comparing CO2 elimination during various frequencies and tidal volumes of HFV with CO2 elimination during conventional mechanical ventilation. Sinusoidal oscillations were applied at the tracheal cannula. A bias flow provided fresh gas at the top of the tracheal cannula. Three conclusions emerge from the data. 1) HFV enhances gas transport in the chicken as it does in mammals. 2) At low oscillatory flows (amplitude X frequency) CO2 elimination depends on both frequency and tidal volume, whereas at higher flows CO2 elimination depends more strongly on tidal volume. The flow at which this transition occurs is relatively lower than in humans and much lower than in dogs. 3) HFV at volumes below dead space is usually not capable of maintaining adequate gas exchange in the chicken in contrast to results in dogs and humans.

TIDAL VOLUME DEAD-SPACE RELATIONSHIP DURING HIGH-FREQUENCY VENTILATION

The Lancet ◽  
1983 ◽  
Vol 322 (8363) ◽  
pp. 1360 ◽  
Author(s):  
J.G. Whitwam ◽  
M.K. Chakrabarti ◽  
G. Gordon
Keyword(s):  
Tidal Volume ◽  
Dead Space ◽  
High Frequency ◽  
High Frequency Ventilation ◽  
Frequency Ventilation
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