Intensive Care Medicine

, Volume 33, Issue 8, pp 1423–1433

High-frequency oscillatory ventilation reduces lung inflammation: a large-animal 24-h model of respiratory distress

  • Ralf M. Muellenbach
  • Markus Kredel
  • Harun M. Said
  • Bernd Klosterhalfen
  • Bernd Zollhoefer
  • Christian Wunder
  • Andreas Redel
  • Michael Schmidt
  • Norbert Roewer
  • Jörg Brederlau
Experimental

DOI: 10.1007/s00134-007-0708-x

Cite this article as:
Muellenbach, R.M., Kredel, M., Said, H.M. et al. Intensive Care Med (2007) 33: 1423. doi:10.1007/s00134-007-0708-x

Abstract

Objective

High-frequency oscillatory ventilation (HFOV) may reduce ventilator-induced lung injury in experimental neonatal respiratory distress. However, these data permit no conclusions for large animals or adult patients with acute respiratory distress syndrome (ARDS), because in neonates higher frequencies and lower amplitudes can be used, resulting in lower tidal volumes (VT) and airway pressures. The aim of this study was to compare gas exchange, lung histopathology and inflammatory cytokine expression during lung-protective pressure-controlled ventilation (PCV) and HFOV in a long-term large-animal model of ARDS.

Design

Prospective, randomized, controlled pilot study.

Setting

University animal laboratory.

Subjects

Sixteen female pigs (55.3 ± 3.9 kg).

Interventions

After induction of ARDS by repeated lavage, the animals were randomly assigned to PCV (VT = 6 ml/kg) and HFOV (6 Hz). After lung injury, a standardised lung recruitment was performed in both groups, and ventilation was continued for 24 h. Measurements and results: After lung recruitment sustained improvements in the oxygenation index were observed in both groups. The mean airway pressure (mPaw) was significantly lower in the HFOV group during the experiment ( p < 0.01). Histologically, lung inflammation was significantly ameliorated in the HFOV group ( p < 0.05). The messenger RNA expression of IL-1-β in lung tissue was significantly lower in the HFOV-treated animals ( p < 0.01).

Conclusions

These data suggest that HFOV compared with conventional lung-protective ventilation can reduce lung inflammation in a large-animal 24-h model of ARDS. Furthermore, it was shown that lung recruitment leads to sustained improvements in gas exchange with a significantly lower mPaw when HFOV is used.

Keywords

High-frequency ventilationIntermittent positive-pressure ventilationAcute respiratory distress syndromeAnimal modelsInflammationMessenger RNA

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Ralf M. Muellenbach
    • 1
  • Markus Kredel
    • 1
  • Harun M. Said
    • 2
  • Bernd Klosterhalfen
    • 3
  • Bernd Zollhoefer
    • 4
  • Christian Wunder
    • 1
  • Andreas Redel
    • 1
  • Michael Schmidt
    • 5
  • Norbert Roewer
    • 1
  • Jörg Brederlau
    • 1
  1. 1.Department of AnaesthesiologyUniversity of WuerzburgWuerzburgGermany
  2. 2.Department of Radiation OncologyUniversity of WuerzburgWuerzburgGermany
  3. 3.Institute of PathologyMunicipal HospitalDuerenGermany
  4. 4.School of MedicineUniversity of WuerzburgWuerzburgGermany
  5. 5.Department of PulmonologyUniversity of WuerzburgWuerzburgGermany