Lucangelo U, Antonaglia V, Zin W A, Berlot G, Fontanesi L, Peratoner A, Bernabè F, Gullo A
Department of Perioperative Medicine, Intensive Care and Emergency, Cattinara Hospital, Trieste University School of Medicine, Strada di Fiume 447, I-34139 Trieste, Italy.
Respir Physiol Neurobiol. 2006 Jan 25;150(1):44-51. doi: 10.1016/j.resp.2005.02.015.
High-frequency percussive ventilation (HFPV) has been proved useful in patients with acute respiratory distress syndrome. However, its physiological mechanisms are still poorly understood. The aim of this work is to evaluate the effects of mechanical loading on the tidal volume and lung washout during HFPV. For this purpose a single-compartment mechanical lung simulator, which allows the combination of three elastic and four resistive loads (E and R, respectively), underwent HFPV with constant ventilator settings. With increasing E and decreasing R the tidal volume/cumulative oscillated gas volume ratio fell, while the duration of end-inspiratory plateau/inspiratory time increased. Indeed, an inverse linear relationship was found between these two ratios. Peak and mean pressure in the model decreased linearly with increasing pulsatile volume, the latter to a lesser extent. In conclusion, elastic or resistive loading modulates the mechanical characteristics of the HFPV device but in such a way that washout volume and time allowed for diffusive ventilation vary agonistically.
高频振荡通气（HFPV）已被证明对急性呼吸窘迫综合征患者有用。然而，其生理机制仍知之甚少。这项工作的目的是评估高频振荡通气期间机械负荷对潮气量和肺冲洗的影响。为此，一个单室机械肺模拟器，它允许三种弹性负荷和四种阻力负荷（分别为E和R）相结合，在呼吸机设置恒定的情况下进行高频振荡通气。随着E增加和R降低，潮气量/累积振荡气体体积比下降，而吸气末平台期持续时间/吸气时间增加。事实上，发现这两个比值之间存在反线性关系。模型中的峰值压力和平均压力随着脉动体积的增加而线性下降，后者下降幅度较小。总之，弹性或阻力负荷调节高频振荡通气设备的机械特性，但冲洗量和扩散通气允许的时间以拮抗方式变化。
