Lucangelo U, Antonaglia V, Zin W A, Fontanesi L, Peratoner A, Bird F M, Gullo A
Department of Perioperative Medicine, Intensive Care and Emergency, Cattinara Hospital, Trieste University School of Medicine, Strada di Fiume 447, I-34139, Italy.
Respir Physiol Neurobiol. 2004 Aug 20;142(1):81-91. doi: 10.1016/j.resp.2004.04.005.
High-frequency percussive ventilation (HFPV) has proved its unique efficacy in the treatment of acute respiratory distress, when conventional mechanical ventilation (CMV) has demonstrated a limited response. We analysed flow (V(dot)), volume (V) and airway pressure (Paw) during ventilation of a single-compartment mechanical lung simulator, in which resistance (R) and elastance (E) values were modified, while maintaining the selected ventilatory settings of the HFPV device. These signals reveal the physical effect of the imposed loads on the output of the ventilatory device, secondary to constant (millisecond by millisecond) alterations in pulmonary dynamics. V(dot), V and Paw values depended fundamentally on the value of R, but their shapes were modified by R and E. Although peak Paw increased 70.3% in relation to control value, mean Paw augmented solely 36.5% under the same circumstances (maximum of 9.4 cm H2O). Finally, a mechanism for washing gas out of the lung was suggested.
高频振荡通气（HFPV）在治疗急性呼吸窘迫方面已证明其独特疗效，而传统机械通气（CMV）的反应有限。我们分析了单腔机械肺模拟器通气期间的流量（V̇）、容积（V）和气道压力（Paw），其中在保持HFPV设备选定通气设置的同时，对阻力（R）和弹性（E）值进行了修改。这些信号揭示了由于肺动力学的持续（逐毫秒）变化而施加的负荷对通气设备输出的物理影响。V̇、V和Paw值基本取决于R的值，但其形态会受到R和E的影响。尽管峰值Paw相对于对照值增加了70.3%，但在相同情况下平均Paw仅增加了36.5%（最大为9.4 cm H₂O）。最后，提出了一种将气体从肺中清除的机制。
