The usefulness of combined high-frequency percussive ventilation during acute respiratory failure after smoke inhalation

• Published in: Burns Vol. 24; no. 1; pp. 34 - 38
• Main Authors: Reper, P., Dankaert, R., van Hille, F., van Laeke, P., Duinslaeger, L., Vanderkelen, A.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-02-1998; Elsevier Science
• Subjects: Acute Disease; Acute respiratory failure; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bronchiolitis Obliterans - etiology; Burns; Burns - complications; Carbon Dioxide - blood; Chemical and industrial products toxicology. Toxic occupational diseases; Combined high-frequency ventilation; Female; Gas, fumes; High-Frequency Jet Ventilation; High-frequency percussive ventilation; Humans; Hypoxaemia; Lung - physiopathology; Male; Medical sciences; Middle Aged; Multiple Organ Failure - etiology; Oxygen - blood; Pneumonia, Bacterial - etiology; Positive-Pressure Respiration; Pulmonary Gas Exchange - physiology; Respiratory Insufficiency - etiology; Respiratory Insufficiency - physiopathology; Respiratory Insufficiency - therapy; Smoke inhalation; Smoke Inhalation Injury - etiology; Smoke Inhalation Injury - physiopathology; Smoke Inhalation Injury - therapy; Survival Rate; Toxicology; Smoke inhalation; Combined high-frequency ventilation; Acute respiratory failure; Hypoxaemia; Burns; High-frequency percussive ventilation; Human; Biomedical equipment; Assisted ventilation; Respiratory disease; Acute; Treatment efficiency; Instrumentation therapy; Respiratory intensive care; Trauma; Inhalation; Burn; Respiratory failure; Complication; Skin; Technique; High frequency; Fumes
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/S0305-4179(97)00037-5

Inhalation injury and bacterial pneumonia represent some of the most important causes of mortality in burn patients. We describe 11 severely burned patients with acute respiratory failure due to inhalation injury who did not respond adequately to conventional respiratory support. High-frequency percussive ventilation (HFPV) is a recent ventilatory mode, which combines the advantages of conventional ventilation with some of those of high-frequency ventilation. Seven patients developed pulmonary infection during the acute phase; one patient died of multiple organ failure on day 25. All the other patients survived; two developed bronchiolitis obliterans symptoms before discharge.
No side-effects were noted and haemodynamic tolerance of HFPV was excellent.
Our findings suggest that HFPV can improve pulmonary function and gas exchange in these catastrophic pulmonary failures following inhalation injury.