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Use of Combined Higb-Frequency Oscillation and Intermittent Mandatory Ventilation in Rabbits with Saline-Lavaged Lungs

Department of Pediatrics, University of Maryland, 22 S Greene St, Baltimore, MD 21201.

Wiel J. Maertzdorf, MD

Department of Neonatology, Academic Hospital Maastricht, University of Limburg, Maastricht, The Netherlands

Frans J. Walther, MD, PhD

Department of Neonatology, Academic Hospital Maastricht, University of Limburg, Maastricht, The Netherlands

We combined high-frequency oscillation ventilation (HFOV) with intermittent mandatory ventilation (IMV) in rabbits with surfactant-depleted lungs by saline la vage. Thirteen rabbits were initially ventilated with con stant-flow, time-cycled, pressure-limited ventilators and 100% oxygen at a peak inspiratory pressure to keep arterial carbon dioxide tension (PaCOz) below 50 mm Hg. Group 1 (n = 6) received only IMV for 3 hours and Group 2 (n = 7), combined HFOV/IMV for 3 hours. HFOV was delivered at 15 Hz and a tidal volume of 2 ml/ kg. Arterial blood gases were measured every 15 min utes. In Group 1, arterial oxygen tension (PaO ₂) de creased from 71 ± 5 to 60 ± 7 mm Hg (mean ± standard error of the mean), PaCO₂ increased from 34 ± 2 to 50 ± 9 mm Hg, and the ventilatory index (PaO ₂/mean airway pressure x fraction of oxygen in in spired air) decreased from 5.9 ± 0.8 to 4.3 ± 0.6 mm Hg/cm H₂O over the 3-hour period (nonsignificant). In Group 2, PaO₂ increased from 61 ± 6 to 141 ± 12 mm Hg (p < .01), PaCO ₂ decreased from 35 ± 2 to 25 ± 7 mm Hg (nonsignificant), and the ventilatory index in creased during HFOV/IMV from 5.1 ± 0.6 to 12.7 ± 2.2 mm Hg/cm H₂O (p < .001) at a lower mean airway pressure than Group 1 over 3 hours. This indicates that the combination of HFOV and IMV is advantageous in improving pulmonary gas exchange in rabbits' saline- lavaged lungs.

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