TY - JOUR
T1 - Comparison of the ventilation characteristics in two adult oscillators
T2 - a lung model study
AU - Yumoto, Tetsuya
AU - Fujita, Takahisa
AU - Asaba, Sunao
AU - Kanazawa, Shunsuke
AU - Nishimatsu, Atsunori
AU - Yamanouchi, Hideo
AU - Nakagawa, Satoshi
AU - Nagano, Osamu
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: Two recent large randomized controlled trials did not show the superiority of high-frequency oscillatory ventilation (HFOV) in adults with ARDS. These two trials had differing results, and possible causes could be the different oscillators used and their different settings, including inspiratory time % (IT%). The aims of this study were to obtain basic data about the ventilation characteristics in two adult oscillators and to elucidate the effect of the oscillator and IT% on ventilation efficiency. Methods: The Metran R100 or SensorMedics 3100B was connected to an original lung model internally equipped with a simulated bronchial tree. The actual stroke volume (aSV) was measured with a flow sensor placed at the Y-piece. Carbon dioxide (CO2) was continuously insufflated into the lung model (V ̇ CO2), and the partial pressure of CO2 (PCO2) in the lung model was monitored. Alveolar ventilation (V ̇ A; L/min) was estimated as V ̇ CO2 divided by the stabilized value of PCO2. V ̇ A was evaluated with several stroke volume settings in the R100 (IT = 50%) or several airway pressure amplitude settings in the 3100B (IT = 33%, 50%) at a frequency of 6 and 8 Hz, a mean airway pressure of 25 cmH2O, and a bias flow of 30 L/min. Assuming that V ̇ A = frequencya × aSVb, values of a and b were determined. Ventilation efficiency was calculated as V ̇ A divided by actual minute ventilation. Results: The relationship between aSV and V ̇ A or ventilation efficiency were different depending on the oscillator and IT%. The values of a and b were 0 < a < 1 and 1 < b < 2 and were different for three conditions at both frequencies. V ̇ A and ventilation efficiency were highest with R100 (IT = 50%) and lowest with 3100B (IT = 33%) for high aSV ranges at both frequencies. Conclusions: In this lung model study, ventilation characteristics were different depending on the oscillator and IT%. Ventilation efficiency was highest with R100 (IT = 50%) and lowest with 3100B (IT = 33%) for high aSV ranges.
AB - Background: Two recent large randomized controlled trials did not show the superiority of high-frequency oscillatory ventilation (HFOV) in adults with ARDS. These two trials had differing results, and possible causes could be the different oscillators used and their different settings, including inspiratory time % (IT%). The aims of this study were to obtain basic data about the ventilation characteristics in two adult oscillators and to elucidate the effect of the oscillator and IT% on ventilation efficiency. Methods: The Metran R100 or SensorMedics 3100B was connected to an original lung model internally equipped with a simulated bronchial tree. The actual stroke volume (aSV) was measured with a flow sensor placed at the Y-piece. Carbon dioxide (CO2) was continuously insufflated into the lung model (V ̇ CO2), and the partial pressure of CO2 (PCO2) in the lung model was monitored. Alveolar ventilation (V ̇ A; L/min) was estimated as V ̇ CO2 divided by the stabilized value of PCO2. V ̇ A was evaluated with several stroke volume settings in the R100 (IT = 50%) or several airway pressure amplitude settings in the 3100B (IT = 33%, 50%) at a frequency of 6 and 8 Hz, a mean airway pressure of 25 cmH2O, and a bias flow of 30 L/min. Assuming that V ̇ A = frequencya × aSVb, values of a and b were determined. Ventilation efficiency was calculated as V ̇ A divided by actual minute ventilation. Results: The relationship between aSV and V ̇ A or ventilation efficiency were different depending on the oscillator and IT%. The values of a and b were 0 < a < 1 and 1 < b < 2 and were different for three conditions at both frequencies. V ̇ A and ventilation efficiency were highest with R100 (IT = 50%) and lowest with 3100B (IT = 33%) for high aSV ranges at both frequencies. Conclusions: In this lung model study, ventilation characteristics were different depending on the oscillator and IT%. Ventilation efficiency was highest with R100 (IT = 50%) and lowest with 3100B (IT = 33%) for high aSV ranges.
KW - Actual stroke volume
KW - Adult oscillator
KW - High-frequency oscillatory ventilation (HFOV)
KW - Inspiratory time % (IT%)
KW - Ventilation efficiency
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U2 - 10.1186/s40635-019-0229-2
DO - 10.1186/s40635-019-0229-2
M3 - Article
AN - SCOPUS:85131337539
SN - 2197-425X
VL - 7
JO - Intensive Care Medicine Experimental
JF - Intensive Care Medicine Experimental
IS - 1
M1 - 15
ER -