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Intensive Care Medicine
Published in: Intensive Care Medicine 1/2008

01-01-2008 | Original

High-frequency percussive ventilation attenuates lung injury in a rabbit model of gastric juice aspiration

Authors: Jérôme Allardet-Servent, Fabienne Bregeon, Stéphane Delpierre, Jean-Guillaume Steinberg, Marie-José Payan, Sylvie Ravailhe, Laurent Papazian

Published in: Intensive Care Medicine | Issue 1/2008

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Abstract

Objective

To test the effects of high-frequency percussive ventilation (HFPV) compared with high-frequency oscillatory ventilation (HFOV) and low-volume conventional mechanical ventilation (LVCMV), on lung injury course in a gastric juice aspiration model.

Design

Prospective, randomized, controlled, in-vivo animal study.

Setting

University animal research laboratory.

Subjects

Forty-three New Zealand rabbits.

Interventions

Lung injury was induced by intratracheal instillation of human gastric juice in order to achieve profound hypoxaemia (PaO2/FIO2 ≤ 50). Animals were ventilated for 4 h after randomization in one of the following four groups: HFPV (median pressure 15 cmH2O); LVCMV (VT 6 ml kg–1 and PEEP set to reach 15 cmH2O plateau pressure); HFOV (mean pressure 15 cmH2O); and a high-volume control group HVCMV (VT 12 ml kg–1 and ZEEP).

Measurements and results

Static respiratory compliance increased after the ventilation period in the HFPV, LVMCV and HFOV groups, in contrast with the HVCMV group. PaO2/FIO2 improved similarly in the HFPV, LVCMV and HFOV groups, and remained lower in the HVCMV group than in the three others. Lung oedema, myeloperoxidase and histological lung injury score were higher in the HVCMV group, but not different among all others. Arterial lactate markedly increased after 4 h of ventilation in the HVCMV group, while lower but similar levels were observed in the three other groups.

Conclusion

HFPV, like HFOV and protective CMV, improves respiratory mechanics and oxygenation, and attenuates lung damage. The HFPV provides attractive lung protection, but further studies should confirm these results before introducing HFPV into the clinical arena.
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Metadata
Title
High-frequency percussive ventilation attenuates lung injury in a rabbit model of gastric juice aspiration
Authors
Jérôme Allardet-Servent
Fabienne Bregeon
Stéphane Delpierre
Jean-Guillaume Steinberg
Marie-José Payan
Sylvie Ravailhe
Laurent Papazian
Publication date
01-01-2008
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 1/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0848-z

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