Abstract
High-frequency ventilators (HFV) use increased respiratory rates and decreased tidal volumes to achieve gas exchange similar to conventional mechanical ventilators (CMV). This reverses the relative importance of convection and diffusion to gas exchange. There are currently 3 major types of HFV. They differ from each other in how gas is delivered, how they work, and what physiological effects they have. Conclusions drawn using one type of HFV cannot necessarily be applied to the others. This review examines the different types of HFV as well as the studies that have been conducted using HFV. It stresses the role that HFV may play in the surgical intensive care unit. The one certain indication presently for HFV is in patients with a bronchopleural fistula. It may also be useful as an adjunct to endoscopy and in adult respiratory distress syndrome (ARDS). If the underlying lung disease cannot be reversed (i.e., end-stage fibrotic ARDS), HFV has little to offer.
Résumé
L'emploi de ventilateurs à haute fréquence (HFV) repose sur l'augmentation de la fréquence respiratoire et la diminution des volumes du flux gazeux qui permettent d'obtenir des échanges gazeux similaires à ceux fournis par les ventilateurs mécaniques conventionnels (CMV). Ceci inverse l'importance relative de la convection et de la diffusion des échanges gazeux. Trois types de ventilateurs à haute fréquence sont actuellement disponibles. Ils sont différents les uns des autres en ce qui concerne la manière dont le gaz est distribué, la façon dont ils travaillent, les effets physiologiques qu'ils entrainent. Les conclusions tirées de l'emploi de l'un d'eux ne peuvent s'appliquer nécessairement aux autres. Cet article est consacré à l'étude des différents types de ventilateurs à haute fréquence ainsi qu'aux travaux dont ils ont été l'objet. Il souligne le rôle que peut jouer le ventilateur à haute fréquence dans une unité de soins intensifs. L'indication élective de l'emploi de ce type de ventilateur est la fistule broncho-pleurale. Il peut jouer un rôle complémentaire au cours de l'endoscopie et du syndrome de détresse respiratoire de l'adulte. En revanche si la maladie pulmonaire est irréversible (le stade terminal du syndrome précité: la fibröse) il est de peu d'efficacité.
Resumen
Los ventiladores de alta frecuencia (VAF) utilizan elevadas frecuencias respiratorias y bajos volúmenes corrientes para lograr un intercambio gaseoso similar al que producen los ventiladores mecánicos convencionales (VMC), lo cual revierte la importancia relativa de la convección y la difusión en el intercambio gaseoso. Actualmente existen 3 tipos principales de VAF. Estos se diferencian en cuanto a la manera como se administra el gas, a la manera como funcionan, y a los efectos fisiológicos que producen. Las conclusiones que puedan derivarse del uso de un tipo determinado de VAF no necesariamente pueden ser aplicadas a los otros. La presente revisión hace un examen de los diferentes tipos de VAF y de los estudios realizados con el uso de VAF, y hace énfasis en el papel que los VAF pueden jugar en la unidad de cuidado intensivo quirúrgico. La indicatión más clara para VAF es la fistula broncopleural. También pueden ser útiles como adyuvantes en endoscopia y en el síndrome de dificultad respiratoria del adulto (SDRA). Si la conditión del pulmón afectado es irreversible (por ejemplo en la fase terminal fibrótica del SDRA), los VAF tienen muy poco que ofrecer.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Sjostrand, U.: Summary of experimental and clinical features of high-frequency positive-pressure ventilation-HFPPV. Acta Anaeth. Scand. [Suppl.]64:165, 1977
Sanders, R.D.: Two ventilating attachments for bronchoscopes. Del. Med. J.39:170, 1967
Klain, M., Smith, R.B.: High-frequency percutaneous transtracheal jet ventilation. Crit. Care Med.5:280, 1977
Butler, W.J., Bonn, D.J., Bryan, A.C., Froese, A.B.: Ventilation by high-frequency oscillation in humans. Anesth. Analg.59:571, 1980
King, M., Phillips, D.M., Zidulka, A., Chang, H.K.: Tracheal mucus clearance in high-frequency oscillation. Am. Rev. Respir. Dis.130:703, 1984
Kolton, M.: A review of high-frequency oscillation. Canad. Anaesth. Soc. J.31:416, 1984
Chang, H.K., Harf, A.: High-frequency ventilation: A review. Respir. Physiol.57:135, 1984
Sladen, A., Guntupalli, K., Klain, M.: High-frequency jet ventilation versus intermittent positive-pressure ventilation. Crit. Care Med.12:788, 1984
Turnbull, A.D., Carlon, G., Howland, W.S., Beattie, E.J., Jr.: High-frequency jet ventilation in major airway or pulmonary disruption. Ann. Thorac. Surg.32:468, 1981
Rouby, J.J., Fusciardi, J., Bourgain, J.L., Viars, P.: High-frequency jet ventilation in postoperative respiratory failure: Determinants of oxygenation. Anesthesiology59:281, 1983
Beamer, W.C., Prough, D.S., Royster, R.L., Johnston, W.E., Johnson, J.C.: High-frequency jet ventilation produces auto-PEEP. Crit. Care Med.12:734, 1984
Schuster, D.P., Snyder, J.V., Klain, M., Grenvik, A.: High-frequency jet ventilation during the treatment of acute fulminant pulmonary edema. Chest80:682, 1981
Schuster, D.P., Klain, M., Snyder, J.V.: Comparison of high-frequency jet ventilation to conventional ventilation during severe acute respiratory failure in humans. Crit. Care Med.10:625, 1982
Carlon, G.C., Howland, W.S., Groeger, J.S., Ray, C., Miodownike, S.: Role of high-frequency jet ventilation in the management of respiratory failure. Crit. Care Med.12:777, 1984
Carlon, G.C., Howland, W.S., Ray, C., Miodownike, S., Griffin, J.P., Groeger, J.S.: High-frequency jet ventilation: A prospective, randomized evaluation. Chest84:551, 1983
Hurst, J.M., Dehtaven, C.B.: Adult respiratory distress syndrome: Improved oxygenation during high-frequency jet ventilation/continuous positive airway pressure. Surgery96:764, 1984
Enderson, B.L., Rice, C.L., Beaver, C.W., Rosen, A.L., Sehgal, L.R., Moss, G.S.: High-frequency ventilation and the accumulation of extravascular lung water. J. Surg. Res.35:443, 1984
Fusciardi, J., Rouby, J.J., Benhamou, D., Viars, P.: Hemodynamic consequences of increasing mean airway pressure during high-frequency jet ventilation. Chest86:30, 1984
Borg, U., Eriksson, I., Sjostrand, U.: High-frequency positive-pressure ventilation (HFPPV): A review based upon its use during bronchoscopy and for laryngoscopy and microlaryngeal surgery under general anesthesia. Anesth. Analg.59:594, 1980
Scheck, P.A., Mallios, C.: Peroral endoscopies using intravenous anesthesia and high-frequency ventilation. Crit. Care. Med.12:803, 1984
Guntupalli, K., Sladen, A., Klain, M.: High-frequency ventilation and tracheobronchial suctioning. Crit. Care. Med.12:791, 1984
Hess, D., Keeports, R., Didyoung, R., Heindel, J., Hostetter, C.: Use of high-frequency jet ventilation to prevent aspiration in a patient with an uncuffed tracheostomy tube. Crit. Care Med.12:918, 1984
Klain, M., Kalla, R., Sladen, A., Guntupalli, K.: High-frequency jet ventilation in weaning the ventilator-dependent patient. Crit. Care Med.12:780, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Enderson, B.L., Rice, C.L. High-frequency ventilation. World J. Surg. 11, 167–172 (1987). https://doi.org/10.1007/BF01656399
Issue Date:
DOI: https://doi.org/10.1007/BF01656399