- Poster presentation
- Published:
From low-tidal-volume ventilation to lowest-tidal-volume ventilation
Critical Care volume 12, Article number: P296 (2008)
Introduction
The therapeutic measures of lung-protective mechanical ventilation used in treatment of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) have revived the interest in high-frequency ventilation (HFV). The reduction of the tidal volume during the conventional ventilation (CV) in terms of low-tidal-volume ventilation is not unboundedly feasible. However, HFV allows a further reduction of tidal volume. Established HFV techniques are high-frequency oscillation (HFO), high-frequency percussive ventilation (HFPV) and superimposed high-frequency jet ventilation (SHFJV). The aim of this study was to evaluate the amelioration of the oxygenation index (OI).
Methods
Twenty-four patients with ALI/ARDS admitted to an ICU were involved. Haemodynamic parameters, blood gas analysis, ventilation pressures (positive end-expiratory pressure (PEEP), plateau and mean airway pressures) were measured. The use of HFV was indicated if the OI was still lower than 200 under CV. The initial parameters (plateau and mean airway pressure, PEEP, I:E ratio, ventilation frequency and FiO2) were chosen as the latest setups of the CV. We randomly used one of the abovementioned techniques to treat patients with ALI/ARDS. The clinically relevant parameters were proved every 4 hours and ventilation was adopted.
Results
All patients treated with HFV showed an amelioration of OI within 24 hours after the start (Figure 1). Furthermore, we registered a significant increase of OI after 24 hours compared with basis CV (Figure 1). However, we did not measure any significant changes between the three HFV techniques at this time point. We observed less/no haemodynamic disturbances with SHFJV and HFPV compared with HFO. It was therefore important to clinically stabilize the patients.
Conclusion
We achieved a significant amelioration of the OI using HFV rather than with CV. Each of the HFV techniques, however, needs a period of a few hours to predict that the technique is responding or nonresponding.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rezaie-Majd, A., Gauss, N., Adler, L. et al. From low-tidal-volume ventilation to lowest-tidal-volume ventilation. Crit Care 12 (Suppl 2), P296 (2008). https://doi.org/10.1186/cc6517
Published:
DOI: https://doi.org/10.1186/cc6517