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Smailys A, Mitchell JR, Doig CJ, et al. High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart. Physiol Rep. 2014;2(3):e00259doi: 10.1002/phy2.259.
Smailys, A., Mitchell, J. R., Doig, C. J., Tyberg, J. V., & Belenkie, I. (2014). High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart. Physiological reports, 2(3), e00259. https://doi.org/10.1002/phy2.259
Smailys, Andrea, et al. "High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart." Physiological reports vol. 2,3 (2014): e00259. doi: https://doi.org/10.1002/phy2.259
Smailys A, Mitchell JR, Doig CJ, Tyberg JV, Belenkie I. High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart. Physiol Rep. 2014 Mar 27;2(3):e00259. doi: 10.1002/phy2.259. Print 2014. PMID: 24760513; PMCID: PMC4002239.
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Physiol Rep. 2014 Mar 27;2(3):e00259. doi: 10.1002/phy2.259. Print 2014.

High-frequency oscillatory ventilation versus conventional ventilation: hemodynamic effects on lung and heart.

Physiological reports

Andrea Smailys, Jamie R Mitchell, Christopher J Doig, John V Tyberg, Israel Belenkie

Affiliations

  1. Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada.

PMID: 24760513 PMCID: PMC4002239 DOI: 10.1002/phy2.259

Abstract

Abstract High-frequency oscillatory ventilation (HFOV) may improve gas exchange in patients who are inadequately ventilated by conventional mechanical ventilation (CV); however, the hemodynamic consequences of switching to HFOV remain unclear. We compared the effects of CV and HFOV on pulmonary vascular conductance and left ventricular (LV) preload and performance at different airway and filling pressures. In anesthetized dogs, we measured LV dimensions, aortic and pulmonary artery (PA) flow, and mean airway ( AW) and pericardial pressures. Catheter-tip pressure manometers measured aortic, LV, left atrial, and PA pressures. The pericardium and chest were closed. At LV end-diastolic pressure (PLVED) = 5 mmHg and 12 mmHg, PEEP was varied (6 cm H2O, 12 cm H2O, and 18 cm H2O) during CV. Then, at airway pressures equal to those during CV, HFOV was applied at 4 Hz, 10 Hz, and 15 Hz. Increased AW decreased pulmonary vascular conductance. As cardiac output increased, conductance increased. At PLVED = 12 mmHg, conductance was greatest during HFOV at 4 Hz. LV preload (i.e., ALV, our index of end-diastolic volume) was similar during HFOV and CV for all conditions. At PLVED = 12 mmHg, SWLV was similar during CV and HFOV, but, at PLVED = 5 mmHg and AW 10 cm H2O, SWLV was lower during HFOV than CV. Compared to pulmonary vascular conductance at higher frequencies, at PLVED = 12 mmHg, conductance was greater at HFOV of 4 Hz. Effects of CV and HFOV on LV preload and performance were similar except for decreased SWLV at PLVED = 5 mmHg. These observations suggest the need for further studies to assess their potential clinical relevance.

Keywords: LV preload; Pulmonary vascular conductance; performance

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