High frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome - a retrospective study

被引:45
作者
Andersen, FA [1 ]
Guttormsen, AB [1 ]
Flaatten, HK [1 ]
机构
[1] Haukeland Hosp, Dept Anaesthesia & Intens Care, N-5021 Bergen, Norway
关键词
acute respiratory distress syndrome; high-frequency oscillation; high-frequency ventilation; mechanical ventilation; respiratory failure; severity of illness;
D O I
10.1034/j.1399-6576.2002.460905.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: At present there are limited data about the effects of high frequency oscillatory ventilation (HFOV) in adult patients with acute respiratory distress syndrome (ARDS). This study evaluates efficacy of HFOV in such patients. Methods: Sixteen ARDS patients, mean age 38.2years (range 18-76), that underwent HFOV between 1997 and 2001 were enrolled in the study and evaluated in retrospect. FIo(2), arterial blood gases, mean airway pressure (mean Paw), blood pressure, heart rate and central venous pressure were recorded by 4, 8, 12, 24, 48 and 72h of HFOV and compared to conventional mechanical ventilation (CMV) at baseline (4h prior to HFOV). Results: On admission to the ICU, mean Simplified Acute Physiology score (SAPS II) was 40.3 (SD 12.6). Main causes of ARDS were pneumonia (9/16) and burn injuries (4/16). At baseline the patients had severe ARDS as noted by a mean lung injury score (LIS) of 3.2 (SD 0.3) and Pao(2)/FIo(2) ratio 12.2 (SD 3.2) kPa. Within 4h of HFOV, Pao(2)/FIo(2) increased to 17.3 (SD 5.9) kPa (P = 0.016). Throughout HFOV, Pao(2)/FIo(2) was significantly higher than at baseline. There were no significant changes in haemodynamic parameters. Ending HFOV after 6.6 (SD 3.2) days, survivors (n = 11) significantly reduced their Sequential Organ Failure Assessment Score (SOFA) compared to baseline. Survival at 3 months was 68.8%. Conclusion: HFOV effectively improves oxygenation without haemodynamic compromise. During HFOV, the SOFA score may predict outcome.
引用
收藏
页码:1082 / 1088
页数:7
相关论文
共 20 条
  • [1] Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome
    Amato, MBP
    Barbas, CSV
    Medeiros, DM
    Magaldi, RB
    Schettino, GDP
    Lorenzi, G
    Kairalla, RA
    Deheinzelin, D
    Munoz, C
    Oliveira, R
    Takagaki, TY
    Carvalho, CRR
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (06) : 347 - 354
  • [2] The American-European Consensus Conference on ARDS, Part 2 - Ventilatory, pharmacologic, supportive therapy, study design strategies and issues related to recovery and remodeling
    Artigas, A
    Bernard, GR
    Carlet, J
    Dreyfuss, D
    Gattinoni, L
    Hudson, L
    Lamy, M
    Marini, JJ
    Matthay, MA
    Pinsky, MR
    Spragg, R
    Suter, PM
    Marini, JJ
    Dreyfuss, D
    Blanch, L
    Burchardi, H
    Hedenstierna, G
    Lemaire, F
    Roussos, C
    Mancebo, J
    Morris, A
    Pesenti, A
    Rossi, A
    Bernard, GR
    Lamy, M
    Van Asbeck, BS
    Brigham, KL
    Dhainaut, JF
    Fowler, AA
    Hyers, TM
    Morel, D
    Rodriguez-Roisin, R
    Schaller, MD
    Pinsky, MR
    Suter, PM
    Hemmer, M
    Torres, A
    Villar, J
    Vincent, JL
    Matthay, MA
    Gattinoni, L
    Leeper, K
    Meyrick, B
    Oppenheimer, L
    Reid, L
    Artigas, A
    Carlet, J
    Hudson, DL
    Murray, JE
    Spragg, R
    [J]. INTENSIVE CARE MEDICINE, 1998, 24 (04) : 378 - 398
  • [3] High-frequency oscillatory ventilation for adult respiratory distress syndrome - A pilot study
    Fort, P
    Farmer, C
    Westerman, J
    Johannigman, J
    Beninati, W
    Dolan, S
    Derdak, S
    [J]. CRITICAL CARE MEDICINE, 1997, 25 (06) : 937 - 947
  • [4] FROESE AB, 1987, AM REV RESPIR DIS, V135, P1363, DOI 10.1007/BF03009896
  • [5] Gerstmann DR, 1996, PEDIATRICS, V98, P1044
  • [6] PULMONARY-FUNCTION AFTER PROLONGED MECHANICAL VENTILATION WITH HIGH-CONCENTRATIONS OF OXYGEN
    GILLBE, CE
    SALT, JC
    BRANTHWAITE, MA
    [J]. THORAX, 1980, 35 (12) : 907 - 913
  • [7] Effects of high-frequency oscillation on endogenous surfactant in an acute lung injury model
    Kerr, CL
    Veldhuizen, RAW
    Lewis, JF
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 164 (02) : 237 - 242
  • [8] APACHE-II - A SEVERITY OF DISEASE CLASSIFICATION-SYSTEM
    KNAUS, WA
    DRAPER, EA
    WAGNER, DP
    ZIMMERMAN, JE
    [J]. CRITICAL CARE MEDICINE, 1985, 13 (10) : 818 - 829
  • [9] Extracorporeal life support for 100 adult patients with severe respiratory failure
    Kolla, S
    Awad, SS
    Rich, PB
    Schreiner, RJ
    Hirschl, RB
    Bartlett, RH
    [J]. ANNALS OF SURGERY, 1997, 226 (04) : 544 - 564
  • [10] KOLTON M, 1982, ANESTH ANALG, V61, P323