The importance of tidal volume and its monitoring during high-frequency ventilation
Authors:
Roubík Karel 1; Pachl Jan 2
Authors‘ workplace:
České vysoké učení technické v Praze, Fakulta biomedicínského inženýrství
1; Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha
2
Published in:
Anest. intenziv. Med., 20, 2009, č. 1, s. 18-24
Category:
Intesive Care Medicine - Review Article
Overview
Even though High-Frequency Ventilation (HFV) meets criteria defining so called protective ventilatory strategy, HFV is not widely used in the clinical practice. Rational initiation of HFV and consequent maintenance of a constant ventilation belong to the limiting factors. Tidal volume is a parameter playing a crucial role in HFV. In the initial phase of HFV, monitoring of tidal volume allows reaching normocapnia promptly. As tidal volume generated by the ventilator depends on the relationship between the output impedance of the ventilator and the connected impedance of the respiratory system, stability of the adjusted ventilatory regimen also depends on this relationship. Furthermore, the effect of the connected impedance changes upon the delivered tidal volume differs in conventional and in high-frequency ventilation. Tidal volume plays also other important roles during high-frequency ventilation; tidal volume affects oxygenation much strongly during HFV than during conventional ventilation. Considering the differences between conventional and high-frequency ventilation and considering the effects of tidal volume changes during HFV, continuous monitoring of tidal volume seems to be essential for the rational and efficient application and control of high--frequency ventilation.
Keywords:
high-frequency ventilation – tidal volume – impedance – ventilator – oxygenation – monitoring
Sources
1. Bollen, W. C., Gijs, Th. J., Sherry, T. High Frequency Oscillatory ventilation compared with conventional mechanical ventilation in adult respiratory distress syndrome: a randomized controlled trial. Critical Care, 2005, 9, p. R430–R439.
2. David, M., Weiler, N., Heinrichs, W. et al. High frequency oscillatory ventilation in adult acute respiratory distress syndrome. Intensive Care Med., 2003, 29, 10, p. 1629–1631.
3. Mehta, S., Lapinsky, S. E., Hallett, D. C. et al. Prospective trial of HFO in adults with acute respiratory distress syndrome. Crit. Care Med., 2001, 29, 7, p. 1360–1369.
4. Derdak, S., Mehta, S., Stewart, T. et al. HFOV for acute Respiratory Distress Syndrome in Adults. Am. J. Respir. Crit. Care Med., 2002, 166, p. 801–808.
5. Ortiz, R. M., Cilley, R. E., Bartlett, R. H. Extracorporeal membrane oxygenation in pediatric respiratory failure. Pediatr. Clin. North. Am., 1987, 34, 1, p. 39–46.
6. Pachl, J., Roubík, K., Waldauf, P., Fric, M., Zábrodský, V. Normocapnic high-frequency oscillatory ventilation affects differently extrapulmonary and pulmonary forms of acute respiratory distress syndrome in adults. Physiological Research, 2006, 55, 1.
7. Rožánek, M., Roubík, K. Influence of The Changes in Pulmonary Mechanics upon the Suitability of Artificial Lung Ventilation Strategy. Biomedical Engineering [CD-ROM]. Zürich : Acta Press, 2004, p. 417–132.
8. Pachl, J., Brož, L., Kripner, J., Fric, M., Roubík, K. et al. Initial Optimal HFOV Continuous Distension Pressure in Prone in a Paediatric Burn: Case Report. Burns, 2004, 30, 2, p. 192–196.
Labels
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2009 Issue 1
Most read in this issue
- Dosage and administration of antibiotics in critically ill patients
- The importance of tidal volume and its monitoring during high-frequency ventilation
- Robot-assisted laparoscopic surgery from the anaesthesiologist’s perspective
- Guidelines for the treatment of invasive candidiasis