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Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury

Journal of Perinatology volume 39, pages 730–736 (2019)Cite this article

Subjects

Abstract

The use of volume guarantee (VG) on high-frequency oscillatory ventilation (HFOV) allows to use fixed very low high-frequency tidal volume (VThf), maintaining adequate CO2 removal while potentially reducing the risk of ventilator-induced lung injury.

Objective

To demonstrate that the use of very low VThf can be protective compared with standard VThf on HFOV combined with VG in a neonatal animal model.

Study design

Experimental study in 2-day-old piglets with induced respiratory distress syndrome ventilated with two different HFOV strategies combined with VG (10 Hz with high VThf versus 20 Hz with very low VThf at similar PaCO2). After 12 h of mechanical ventilation, the pulmonary histologic pattern was analyzed.

Results

We found in the 10 Hz group with the higher VThf compared with the 20 Hz and very low VThf group more evident and more severe histological lesions with inflammatory infiltrate within the alveolar wall and alveolar space, as well as large areas of parenchyma consolidation and areas of alveolar hemorrhage in the more severe cases.

Conclusion

The use of very low VThf compared with higher VThf at similar CO2 removal reduces lung injury in a neonatal animal model of lung injury after prolonged mechanical ventilation with HFOV combined with VG.

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Acknowledgements

The authors thank Dräger Medical GmbH for providing the Babylog VN500 for the present study.

Funding

This study was supported in part by the National Grant of the Instituto de Salud Carlos III and the Fondo Europeo de Desarrollo Regional, FIS 14/00149.

Author information

Authors and Affiliations

  1. Neonatology Department, Hospital Universitario Gregorio Marañón, Biomedical Research Institute Gregorio Marañón, Complutense University of Madrid, Madrid, Spain

    Noelia González-Pacheco, Manuel Sánchez-Luna & Paz Chimenti-Camacho

  2. Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain

    Martín Santos-González & Francisco Tendillo-Cortijo

  3. Servicio de Inmunología, Laboratorio de Inmuno-Biología Molecular, Hospital Universitario Gregorio Marañón, Madrid, Spain

    Paula Palau-Concejo

Authors
  1. Noelia González-Pacheco
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  2. Manuel Sánchez-Luna
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  3. Paz Chimenti-Camacho
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  4. Martín Santos-González
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  5. Paula Palau-Concejo
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  6. Francisco Tendillo-Cortijo
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Corresponding author

Correspondence to Manuel Sánchez-Luna.

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Conflict of interest

MS-L has received advisory board consulting fees from Dräger. The remaining authors declare that they have no conflict of interest.

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González-Pacheco, N., Sánchez-Luna, M., Chimenti-Camacho, P. et al. Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury. J Perinatol 39, 730–736 (2019). https://doi.org/10.1038/s41372-019-0338-5

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