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High‐frequency oscillatory ventilation compared with conventional mechanical ventilation in newborn lambs: Effects of increasing airway pressure on intracranial pressures
Author(s) -
Walker Adrian M.,
Brodecky Vojta A.,
de Preu Nicole D.,
Ritchie Blair C.
Publication year - 1992
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950120105
Subject(s) - medicine , high frequency ventilation , ventilation (architecture) , mechanical ventilation , anesthesia , airway , intracranial pressure , continuous positive airway pressure , mean airway pressure , artificial ventilation , respiratory disease , lung , mechanical engineering , engineering , obstructive sleep apnea
We tested the hypothesis that intracranial pressures and cerebral perfusion pressure in the newborn are more seriously affected by increasing airway pressure during high‐frequency oscillatory ventilation (HFOV) than during conventional mechanical ventilation (CMV). Mean airway pressure was acutely elevated in stepwise fashion to 25 cm H 2 O in six anesthetized, paralyzed newborn lambs. Pressure (mean ± SE) increased similarly during HFOV and CMV in the jugular vein (7 ± 1 and 8 ± 1 cm H 2 O, respectively), the sagittal sinus (6 ± 1 and 7 ± 1 cm H 2 O), and the cerebrospinal fluid of the lateral ventricle (4 ± 1 and 6 ± 1 cm H 2 O). Decreases in arterial blood pressure (− 13 ± 2 and − 10 ± 2 cm H 2 O) and cerebral perfusion pressure (− 17 ± 2 and − 16 ± 2 cm H 2 O) were also similar during HFOV and CMV. Intracranial pressure−volume curves were generated by incrementing cerebrospinal fluid volume in eight lambs. Curves generated during HFOV and CMV were similar, reflecting a similar intracranial compliance during the two ventilatory modes. These data indicate that intracranial compliace and the effects of increasing airway pressure upon intracranial pressures are not significantly different between HFOV and CMV.