Ann Biomed Eng. 2021 Sep;49(9):2377-2388. doi: 10.1007/s10439-021-02767-2. Epub 2021 May 04.

Regional Gas Transport During Conventional and Oscillatory Ventilation Assessed by Xenon-Enhanced Computed Tomography.

Annals of biomedical engineering

Jacob Herrmann, Sarah E Gerard, Joseph M Reinhardt, Eric A Hoffman, David W Kaczka

PMID: 33948747 DOI: 10.1007/s10439-021-02767-2

Abstract

Enhanced intrapulmonary gas transport enables oscillatory ventilation modalities to support gas exchange using extremely low tidal volumes at high frequencies. However, it is unknown whether gas transport rates can be improved by combining multiple frequencies of oscillation simultaneously. The goal of this study was to investigate distributed gas transport in vivo during multi-frequency oscillatory ventilation (MFOV) as compared with conventional mechanical ventilation (CMV) or high-frequency oscillatory ventilation (HFOV). We hypothesized that MFOV would result in more uniform rates of gas transport compared to HFOV, measured using contrast-enhanced CT imaging during wash-in of xenon gas. In 13 pigs, xenon wash-in equilibration rates were comparable between CMV and MFOV, but 21 to 39% slower for HFOV. By contrast, the root-mean-square delivered volume was lowest for MFOV, increased by 70% during HFOV and 365% during CMV. Overall gas transport heterogeneity was similar across all modalities, but gravitational gradients and regional patchiness of specific ventilation contributed to regional ventilation heterogeneity, depending on ventilator modality. We conclude that MFOV combines benefits of low lung stretch, similar to HFOV, but with fast rates of gas transport, similar to CMV.

© 2021. Biomedical Engineering Society.

Keywords: High-frequency ventilation; Mechanical ventilation; Pulmonary gas exchange; Respiratory-gated imaging techniques

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Publication Types

• Journal Article

Grant support

• R41 HL140640/HL/NHLBI NIH HHS/United States
• W81XWH-16-1-0434/U.S. Department of Defense
• 1S10OD018526/NH/NIH HHS/United States
• P30 DK054759/DK/NIDDK NIH HHS/United States
• R01 HL142625/HL/NHLBI NIH HHS/United States