ArticleCritical care (London, England)2006
Imposed work of breathing during high-frequency oscillatory ventilation: a bench study.
Article in Critical care (London, England), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- The Physiological Basis of High-Frequency Oscillatory Ventilation and Current Evidence in Adults and Children: A Narrative Review.Frontiers in physiology · 2022Review
- Outcomes of Severe PARDS on High-Frequency Oscillatory Ventilation - A Single Centre Experience.Indian journal of pediatrics · 2020Article
- Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children.Annals of intensive care · 2019Article
- [Monitoring tidal volumes when using the Ventrain® emergency ventilator].Der Anaesthesist · 2016Article
- Bias flow does not affect ventilation during high-frequency oscillatory ventilation in a pediatric animal model of acute lung injury.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2012Article
- High-frequency oscillatory ventilation and short-term outcome in neonates and infants undergoing cardiac surgery: a propensity score analysis.Critical care (London, England) · 2011Article
- CPAP and HFOV: different guises of the same underlying intensive care strategy for supporting RSV bronchiolitis.Intensive care medicine · 2008Article
- Year in review 2006: Critical Care--Respirology.Critical care (London, England) · 2007Review
- Unloading work of breathing during high-frequency oscillatory ventilation: a bench study.Critical care (London, England) · 2006Article
- Bench-to-bedside review: high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome.Critical care (London, England) · 2006Review
- Allowing for spontaneous breathing during high-frequency oscillation: the key for final success?Critical care (London, England) · 2006Review
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe ventilator and the endotracheal tube impose additional workload in mechanically ventilated patients breathing spontaneously. The total work of breathing (WOB) includes elastic and resistive work. In a bench test we assessed the imposed WOB using 3100 A/3100 B SensorMedics high-frequency oscillatory ventilators.
methodsA computer-controlled piston-driven test lung was used to simulate a spontaneously breathing patient. The test lung was connected to a high-frequency oscillatory ventilation (HFOV) ventilator by an endotracheal tube. The inspiratory and expiratory airway flows and pressures at various places were sampled. The spontaneous breath rate and volume, tube size and ventilator settings were simulated as representative of the newborn to adult range. The fresh gas flow rate was set at a low and a high level. The imposed WOB was calculated using the Campbell diagram.
resultsIn the simulations for newborns (assumed body weight 3.5 kg) and infants (assumed body weight 10 kg) the imposed WOB (mean +/- standard deviation) was 0.22 +/- 0.07 and 0.87 +/- 0.25 J/l, respectively. Comparison of the imposed WOB in low and high fresh gas flow rate measurements yielded values of 1.63 +/- 0.32 and 0.96 +/- 0.24 J/l (P = 0.01) in small children (assumed body weight 25 kg), of 1.81 +/- 0.30 and 1.10 +/- 0.27 J/l (P < 0.001) in large children (assumed body weight 40 kg), and of 1.95 +/- 0.31 and 1.12 +/- 0.34 J/l (P < 0.01) in adults (assumed body weight 70 kg). High peak inspiratory flow and low fresh gas flow rate significantly increased the imposed WOB. Mean airway pressure in the breathing circuit decreased dramatically during spontaneous breathing, most markedly at the low fresh gas flow rate. This led to ventilator shut-off when the inspiratory flow exceeded the fresh gas flow.
conclusionSpontaneous breathing during HFOV resulted in considerable imposed WOB in pediatric and adult simulations, explaining the discomfort seen in those patients breathing spontaneously during HFOV. The level of imposed WOB was lower in the newborn and infant simulations, explaining why these patients tolerate spontaneous breathing during HFOV well. A high fresh gas flow rate reduced the imposed WOB. These findings suggest the need for a demand flow system based on patient need allowing spontaneous breathing during HFOV.
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