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A comparison of high‐frequency jet ventilation and synchronised intermittent mandatory ventilation in preterm lambs
Author(s) -
Musk Gabrielle C.,
Polglase Graeme R.,
Bunnell J. Bert,
Nitsos Ilias,
Tingay David,
Pillow J. Jane
Publication year - 2015
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.23187
Subject(s) - medicine , mean airway pressure , anesthesia , oxygenation , ventilation (architecture) , peak inspiratory pressure , positive end expiratory pressure , intermittent mandatory ventilation , mechanical ventilation , respiratory distress , continuous positive airway pressure , tidal volume , respiratory system , mechanical engineering , engineering , obstructive sleep apnea
Summary Purpose Synchronised intermittent mandatory ventilation (SIMV) and high‐frequency jet ventilation (HFJV) are accepted ventilatory strategies for treatment of respiratory distress syndrome (RDS) in preterm babies. We hypothesised that SIMV and HFJV both facilitate adequate oxygenation and ventilation but that HFJV is associated with less lung injury. Results There were no differences in arterial oxygenation or partial pressure of carbon dioxide despite lower mean airway pressure during SIMV for most of the study. There were no consistent significant differences in end systolic and end diastolic PBF, lung injury data and static lung compliance. Methods Preterm lambs of anaesthetised ewes were instrumented, intubated and delivered by caesarean section after intratracheal suction and instillation of surfactant. Each lamb was managed for 3 hr according to a predetermined algorithm for ventilatory support consistent with open lung ventilation. Pulmonary blood flow (PBF) was measured continuously and pulsatility index was calculated. Ventilatory parameters were recorded and arterial blood gases were measured at intervals. At postmortem, in situ pressure‐volume deflation curves were recorded, and bronchoalveolar lavage fluid and lung tissue were obtained to assess inflammation. Conclusions SIMV and HFJV have comparable clinical efficacy and ventilator pressure requirements when applied with a targeted lung volume recruitment strategy. Pediatr Pulmonol. 2015; 50:1286–1293. © 2015 Wiley Periodicals, Inc.