ArticleCritical care medicine2020
High-Frequency Oscillatory Ventilation and Ventilator-Induced Lung Injury: Size Does Matter.
Article in Critical care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- High-frequency oscillatory ventilation with volume guarantee in infants: a systematic review.Pediatric research · 2025Pooled it
- Simulation of Central Airway Gas Flow Dynamics During Conventional and Multifrequency Ventilation.Journal of biomechanical engineering · 2025Article
- Gas transport mechanisms during high-frequency ventilation.Respiratory research · 2024Review
- Future directions in ventilator-induced lung injury associated cognitive impairment: a new sight.Frontiers in physiology · 2023Review
- Assessment of Heterogeneity in Lung Structure and Function During Mechanical Ventilation: A Review of Methodologies.Journal of engineering and science in medical diagnostics and therapy · 2022Review
- Expiratory high-frequency percussive ventilation: a novel concept for improving gas exchange.Respiratory research · 2022Article
- Unshrinking the baby lung to calm the VILI vortex.Critical care (London, England) · 2022Review
- Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography.Annals of biomedical engineering · 2021Article
- Oscillatory ventilation redux: alternative perspectives on ventilator-induced lung injury in the acute respiratory distress syndrome.Current opinion in physiology · 2021Review
- Mechanical Ventilation Lessons Learned From Alveolar Micromechanics.Frontiers in physiology · 2020Review
- Quantifying Regional Lung Deformation Using Four-Dimensional Computed Tomography: A Comparison of Conventional and Oscillatory Ventilation.Frontiers in physiology · 2020Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesThe theoretical basis for minimizing tidal volume during high-frequency oscillatory ventilation may not be appropriate when lung tissue stretch occurs heterogeneously and/or rapidly. The objective of this study was to assess the extent to which increased ventilation heterogeneity may contribute to ventilator-induced lung injury during high-frequency oscillatory ventilation in adults compared with neonates on the basis of lung size, using a computational model of human lungs.
designComputational modeling study.
settingResearch laboratory. SUBJECTS: High-fidelity, 3D computational models of human lungs, scaled to various sizes representative of neonates, children, and adults, with varying injury severity. All models were generated from one thoracic CT image of a healthy adult male.
interventionsOscillatory ventilation was simulated in each lung model at frequencies ranging from 0.2 to 40 Hz. Sinusoidal flow oscillations were delivered at the airway opening of each model and distributed through the lungs according to regional parenchymal mechanics. MEASUREMENTS AND MAIN
resultsAcinar flow heterogeneity was assessed by the coefficient of variation in flow magnitudes across all acini in each model. High-frequency oscillatory ventilation simulations demonstrated increasing heterogeneity of regional parenchymal flow with increasing lung size, with decreasing ratio of deadspace to total acinar volume, and with increasing frequency above lung corner frequency and resonant frequency. Potential for resonant amplification was greatest in injured adult-sized lungs with higher regional quality factors indicating the presence of underdamped lung regions.
conclusionsThe potential for ventilator-induced lung injury during high-frequency oscillatory ventilation is enhanced at frequencies above lung corner frequency or resonant frequency despite reduced tidal volumes, especially in adults, due to regional amplification of heterogeneous flow. Measurements of corner frequency and resonant frequency should be considered during high-frequency oscillatory ventilation management.
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Registered trials
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