High-frequency Oscillatory Ventilation
| العنوان: | High-frequency Oscillatory Ventilation |
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| المؤلفون: | Vicki T. Winter, Bradley A. Yoder, Theresa M. Siler-Khodr, Jacqueline J. Coalson |
| المصدر: | American Journal of Respiratory and Critical Care Medicine. 162:1867-1876 |
| بيانات النشر: | American Thoracic Society, 2000. |
| سنة النشر: | 2000 |
| مصطلحات موضوعية: | Lung Diseases, Male, Pulmonary and Respiratory Medicine, medicine.medical_treatment, High-Frequency Ventilation, Gestational Age, Lung injury, Critical Care and Intensive Care Medicine, Pulmonary function testing, Positive-Pressure Respiration, Fraction of inspired oxygen, Tidal Volume, medicine, Animals, Humans, Tidal volume, Bronchopulmonary Dysplasia, Mechanical ventilation, Respiratory Distress Syndrome, Newborn, business.industry, High-frequency ventilation, Respiratory disease, Infant, Newborn, Pulmonary Surfactants, Mechanics, respiratory system, medicine.disease, Combined Modality Therapy, Trachea, Animals, Newborn, Chronic Disease, Respiratory Mechanics, Breathing, Cytokines, Female, business, Papio |
| الوصف: | Acute lung injury models demonstrate that high-frequency oscillatory ventilation (HFOV) improves lung function, mechanics, and histopathology with reduced inflammatory mediators. Neither human HFOV trials nor premature animal studies have adequately evaluated these factors during prolonged HFOV. The objective of this study was to compare the effect of prolonged HFOV with low tidal volume (VT) positive pressure ventilation (LV-PPV) in an immature baboon model for neonatal chronic lung disease (CLD). After administration of prenatal steroids, 18 baboons were delivered by cesarean section at 125 d (term = 185 d), treated with exogenous surfactant, then randomized to either HFOV or LV-PPV by 5 min age. Animals were maintained on oxygen on an "as needed" basis and on nutritional support for 1 to 2 mo. Serial pulmonary function testing (PFT) was performed. Tracheal aspirates were analyzed for interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNF-alpha), IL-1beta, and IL-10. Lungs were inflation fixed for morphometric analyses. From 12 h through 10 d age, HFOV animals had consistently lower fraction of inspired oxygen (FI(O(2))) and higher a/ A ratio. Pulmonary mechanics were significantly improved in HFOV animals at nearly every time point analyzed from 12 h to 28 d. There were no consistent differences in tracheal IL-6, TNF-alpha, IL-1beta, or IL-10 after 24 h age. Higher tracheal IL-8 values and macrophage/monocyte numbers were found in LV-PPV animals after 1 wk and 3 to 4 wk ventilation. Both groups exhibited pulmonary pathologic lesions found in extremely immature humans, including alveolar hypoplasia, variable saccular wall fibrosis, and minimal airway disease. HFOV animals had significantly better lung inflation patterns by panel of standards analysis. Early, prolonged HFOV significantly improved early lung function with sustained improvement in pulmonary mechanics out to 28 d. Immature baboons managed with HFOV had less pulmonary inflammation in the hyaline membrane disease (HMD) recovery phase. Though enhanced alveolization was not observed, HFOV for 1 to 2 mo resulted in consistently more uniform lung inflation than LV-PPV. |
| تدمد: | 1535-4970 1073-449X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::16e46046cfb822c60ec0e609789da510 https://doi.org/10.1164/ajrccm.162.5.9912145 |
| رقم الأكسشن: | edsair.doi.dedup.....16e46046cfb822c60ec0e609789da510 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15354970 1073449X |
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