High-frequency percussive ventilation improves oxygenation in trauma patients with acute respiratory distress syndrome: a retrospective review

Alexander Eastman, Dean Holland, Jason Higgins, Brian Smith, Jennifer Delagarza, Craig Olson, Scott Brakenridge, Kousta Foteh, Randall S Friese

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: High-frequency percussive ventilation (HFPV), a hybrid of conventional mechanical ventilation and high-frequency oscillatory ventilation, has been used to salvage patients with persistent hypoxemia on conventional mechanical ventilation. We hypothesized that oxygenation would improve in injured patients with severe hypoxemia who were converted to HFPV after initial management with conventional ventilation. Methods: Chart review identified patients with acute respiratory distress syndrome (ARDS) managed with HFPV. Oxygenation parameters (oxygenation index, OI; Pao2/Fio2 ratio, P/F) and mean airway pressures (mPaw) were recorded at baseline and at 1 to 4, 8 to 12, and 12 to 24 hours after initiation of HFPV. Values at baseline and each time point after conversion to HFPV were compared by using analysis of variance or Kruskal-Wallis tests. Results: Twelve patients, over 24 months, were reviewed. Baseline measurements were OI: 42.2 ± 33, P/F: 70 ± 31, (median ± interquartile range), and mPaw: 29 ± 8 (mean ± standard deviation) cm H2O. After initiation of HFPV, mPaw did not differ from baseline. There was an improvement in OI (P = .01) from baseline at 12 to 24 hours after initiation of HFPV and in P/F at 12 to 24 hours (P = .002) and 8 to 12 hours (P = .001) after initiation of HFPV. Conclusions: HFPV may improve oxygenation in patients with ARDS without a concomitant increase in mPaw. A randomized trial of HFPV versus conventional ventilation in trauma patients is needed.

Original languageEnglish (US)
Pages (from-to)191-195
Number of pages5
JournalAmerican Journal of Surgery
Volume192
Issue number2
DOIs
StatePublished - Aug 2006
Externally publishedYes

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High-Frequency Ventilation
Adult Respiratory Distress Syndrome
Wounds and Injuries
Artificial Respiration
Ventilation
Analysis of Variance

Keywords

  • Acute respiratory distress syndrome
  • High-frequency ventilation
  • Lung injury
  • oxygenation
  • Trauma

ASJC Scopus subject areas

  • Surgery

Cite this

High-frequency percussive ventilation improves oxygenation in trauma patients with acute respiratory distress syndrome : a retrospective review. / Eastman, Alexander; Holland, Dean; Higgins, Jason; Smith, Brian; Delagarza, Jennifer; Olson, Craig; Brakenridge, Scott; Foteh, Kousta; Friese, Randall S.

In: American Journal of Surgery, Vol. 192, No. 2, 08.2006, p. 191-195.

Research output: Contribution to journalArticle

Eastman, Alexander ; Holland, Dean ; Higgins, Jason ; Smith, Brian ; Delagarza, Jennifer ; Olson, Craig ; Brakenridge, Scott ; Foteh, Kousta ; Friese, Randall S. / High-frequency percussive ventilation improves oxygenation in trauma patients with acute respiratory distress syndrome : a retrospective review. In: American Journal of Surgery. 2006 ; Vol. 192, No. 2. pp. 191-195.
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abstract = "Background: High-frequency percussive ventilation (HFPV), a hybrid of conventional mechanical ventilation and high-frequency oscillatory ventilation, has been used to salvage patients with persistent hypoxemia on conventional mechanical ventilation. We hypothesized that oxygenation would improve in injured patients with severe hypoxemia who were converted to HFPV after initial management with conventional ventilation. Methods: Chart review identified patients with acute respiratory distress syndrome (ARDS) managed with HFPV. Oxygenation parameters (oxygenation index, OI; Pao2/Fio2 ratio, P/F) and mean airway pressures (mPaw) were recorded at baseline and at 1 to 4, 8 to 12, and 12 to 24 hours after initiation of HFPV. Values at baseline and each time point after conversion to HFPV were compared by using analysis of variance or Kruskal-Wallis tests. Results: Twelve patients, over 24 months, were reviewed. Baseline measurements were OI: 42.2 ± 33, P/F: 70 ± 31, (median ± interquartile range), and mPaw: 29 ± 8 (mean ± standard deviation) cm H2O. After initiation of HFPV, mPaw did not differ from baseline. There was an improvement in OI (P = .01) from baseline at 12 to 24 hours after initiation of HFPV and in P/F at 12 to 24 hours (P = .002) and 8 to 12 hours (P = .001) after initiation of HFPV. Conclusions: HFPV may improve oxygenation in patients with ARDS without a concomitant increase in mPaw. A randomized trial of HFPV versus conventional ventilation in trauma patients is needed.",
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AU - Eastman, Alexander

AU - Holland, Dean

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AU - Delagarza, Jennifer

AU - Olson, Craig

AU - Brakenridge, Scott

AU - Foteh, Kousta

AU - Friese, Randall S

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N2 - Background: High-frequency percussive ventilation (HFPV), a hybrid of conventional mechanical ventilation and high-frequency oscillatory ventilation, has been used to salvage patients with persistent hypoxemia on conventional mechanical ventilation. We hypothesized that oxygenation would improve in injured patients with severe hypoxemia who were converted to HFPV after initial management with conventional ventilation. Methods: Chart review identified patients with acute respiratory distress syndrome (ARDS) managed with HFPV. Oxygenation parameters (oxygenation index, OI; Pao2/Fio2 ratio, P/F) and mean airway pressures (mPaw) were recorded at baseline and at 1 to 4, 8 to 12, and 12 to 24 hours after initiation of HFPV. Values at baseline and each time point after conversion to HFPV were compared by using analysis of variance or Kruskal-Wallis tests. Results: Twelve patients, over 24 months, were reviewed. Baseline measurements were OI: 42.2 ± 33, P/F: 70 ± 31, (median ± interquartile range), and mPaw: 29 ± 8 (mean ± standard deviation) cm H2O. After initiation of HFPV, mPaw did not differ from baseline. There was an improvement in OI (P = .01) from baseline at 12 to 24 hours after initiation of HFPV and in P/F at 12 to 24 hours (P = .002) and 8 to 12 hours (P = .001) after initiation of HFPV. Conclusions: HFPV may improve oxygenation in patients with ARDS without a concomitant increase in mPaw. A randomized trial of HFPV versus conventional ventilation in trauma patients is needed.

AB - Background: High-frequency percussive ventilation (HFPV), a hybrid of conventional mechanical ventilation and high-frequency oscillatory ventilation, has been used to salvage patients with persistent hypoxemia on conventional mechanical ventilation. We hypothesized that oxygenation would improve in injured patients with severe hypoxemia who were converted to HFPV after initial management with conventional ventilation. Methods: Chart review identified patients with acute respiratory distress syndrome (ARDS) managed with HFPV. Oxygenation parameters (oxygenation index, OI; Pao2/Fio2 ratio, P/F) and mean airway pressures (mPaw) were recorded at baseline and at 1 to 4, 8 to 12, and 12 to 24 hours after initiation of HFPV. Values at baseline and each time point after conversion to HFPV were compared by using analysis of variance or Kruskal-Wallis tests. Results: Twelve patients, over 24 months, were reviewed. Baseline measurements were OI: 42.2 ± 33, P/F: 70 ± 31, (median ± interquartile range), and mPaw: 29 ± 8 (mean ± standard deviation) cm H2O. After initiation of HFPV, mPaw did not differ from baseline. There was an improvement in OI (P = .01) from baseline at 12 to 24 hours after initiation of HFPV and in P/F at 12 to 24 hours (P = .002) and 8 to 12 hours (P = .001) after initiation of HFPV. Conclusions: HFPV may improve oxygenation in patients with ARDS without a concomitant increase in mPaw. A randomized trial of HFPV versus conventional ventilation in trauma patients is needed.

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