High frequency percussive ventilation in burn patients: hemodynamics and gas exchange

High frequency percussive ventilation in burn patients: hemodynamics and gas exchange

High frequency percussive ventilation (HFPV) is a recent ventilatory mode, which combines conventional cycles with high frequency percussions. HFPV was initially instituted as salvage therapy after acute respiratory failure following smoke inhalation injury achieving in each case a dramatic improvem...

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Bibliographic Details
Published in:Burns Vol. 29; no. 6; pp. 603 - 608
Main Authors: Reper, P, Van Bos, R, Van Loey, K, Van Laeke, P, Vanderkelen, A
Format: Journal Article
Language:English
Published: Netherlands Elsevier Ltd 01-09-2003
Subjects:
Adult
Barotrauma
Blood Gas Analysis - methods
Blood Pressure - physiology
Burns
Carbon Dioxide - blood
Cardiac Output - physiology
Conventional ventilation
Female
Heart Rate - physiology
Hemodynamics - physiology
High frequency percussive ventilation
High-Frequency Ventilation - methods
Humans
Hypoxemia
Male
Middle Aged
Oxygen - blood
Positive-Pressure Respiration - methods
Pulmonary Ventilation - physiology
Respiration
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
Smoke Inhalation Injury - complications
Smoke Inhalation Injury - physiopathology
Smoke Inhalation Injury - therapy
Hypoxemia
High frequency percussive ventilation
Conventional ventilation
Burns
Barotrauma
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Summary:High frequency percussive ventilation (HFPV) is a recent ventilatory mode, which combines conventional cycles with high frequency percussions. HFPV was initially instituted as salvage therapy after acute respiratory failure following smoke inhalation injury achieving in each case a dramatic improvement of blood oxygenation, PaCO 2 and ventilatory pressures. This study investigates the influence of HFPV on hesmodynamics, blood oxygenation and ventilatory parameters in eight stable ICU burn patients requiring artificial ventilatory support during a postoperative period following traumatic injury. Periods of 2 h were analysed receiving conventional ventilation and HFPV with a high frequency of 400 and 800 cycles/min. Hemodynamic data were not significantly modified; peak inspiratory pressure was significantly lower under HFPV but mean airway pressure was unchanged. Blood oxygenation and CO 2 elimination were significantly improved under HFPV. No side effects were noted. These observations suggest that HFPV could improve pulmonary gas exchanges under lower peak pressures and without hemodynamic compromise. HFPV could represent an interesting alternative open lung strategy method to improve alveolar recruitment.
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ISSN:0305-4179
1879-1409
DOI:10.1016/S0305-4179(03)00068-8