Abstract
Combined high frequency oscillation (HFO) with conventional ventilation was used on a group of 12 ventilator dependent neonates in order to investigate the frequency response of the respiratory system to HFO. Pressure oscillations were measured at the airway opening with a transducer and volume oscillations at the chest wall using a calibrated respiratory jacket. Pressure oscillations increased with increasing frequency but the oscillating volumes showed a variable pattern with maximum oscillating volumes of up to 4 ml/kg. Three babies showed no change in volume between 2–25 Hz, 3 babies showed increasing volumes up to 25 Hz and the remainder showed a maximum volume (or resonant frequency) at 15–20 Hz. Oscillating volumes were higher when the conventional ventilator was in the expiratory phase. The differences in frequency response were unrelated to severity of lung disease, birth weight, age at testing, or size of the endotracheal (ET) tube. Local factors in the ET tube and large airways may account for some of the observed differences.
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Abbreviations
- CV:
-
conventional ventilation
- ET:
-
endotracheal
- HFO:
-
high frequency oscillation
References
Bhutani VK, Rubenstein D, Shaffer TH (1981) Pressure-volume relationships of tracheae in fetal newborn and adult rabbits. Respir Physiol 43:221–231
Boros SJ, Mammel MC, Lewallen PK, Coleman JM, Gordon MJ, Ophoven J (1986) Necrotising tracheobronchitis: a complication of high-frequency ventilation. J Pediatr 109:95–100
Boynton BR, Mannino FL, Davis RF, Kopotic RJ, Friederichsen G (1984) Combined high-frequency oscillatory ventilation and intermittent mandatory ventilation in critically ill neonates. J Pediatr 105:297–302
Chang HK, Mortola JP (1981) Fluid dynamic factors in tracheal pressure measurement. J Appl Physiol Respir Environ Exercise Physiol 51:218–225
Dorkin HL, Stark AR, Werthammer JW, Strieder DJ, Fredberg JJ, Frantz ID III (1983) Respiratory system impedance from 4 to 40 Hz in paralyzed intubated infants with respiratory disease. J Clin Invest 72:903–910
Field D, Milner AD, Hopkin IE (1984) High and conventional rates of positive pressure ventilation. Arch Dis Child 59:1151–1154
Helms P, Taylor BW, Milner AD, Hatch DJ (1982) Critical assessment of jacket plethysmographs for use in young children. J Appl Physiol Respirat Environ Exercise Physiol 52:267–273
Hoskyns EW, Milner AD, Hopkin I (1991) Measurement of volumes in high frequency oscillation in neonates. J Bio Eng (in press)
Kolton M, Cattran CB, Kent G, Volgyesi G, Froese AB (1982) Oxygenation during high frequency ventilation compared with conventional mechanical ventilation in two models of lung injury. Anesth Analg 61:323–332
Lunkenheimer PP, Rafflenbeul W, Keller H, Frank I, Dickhut HH, Fuhrmann C (1972) Application of transtracheal pressure oscillations as a modification of “diffusion respiration”. Br J Anaesth 44:627
McCann EM, Goldman SL, Brady JP (1987) Pulmonary function in the sick newborn infant. Pediatr Res 21:313–325
Slutsky AS, Kamm RD, Drazen JM (1983) High frequency oscillatory ventilation using tidal volumes smaller than the anatomical dead space. Int Anesthesiol Clin 21:161–181
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Hoskyns, E.W., Milner, A.D. & Hopkin, I.E. Combined conventional ventilation with high frequency oscillation in neonates. Eur J Pediatr 150, 357–361 (1991). https://doi.org/10.1007/BF01955940
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DOI: https://doi.org/10.1007/BF01955940