Crawford M, Rehder K
Anesthesiology. 1985 Mar;62(3):298-304. doi: 10.1097/00000542-198503000-00015.
Pulmonary gas exchange during conventional mechanical ventilation (CMV) (tidal volume 10 ml/kg, rate 8-10 breaths/min) was compared with that during high-frequency small-volume ventilation (HFV) in 67 patients undergoing anesthesia for various surgical procedures. HFV was studied at oscillation frequencies ranging from 3 to 18 Hz with stroke volumes of 0.8 to 2.2 ml/kg. Adequate pulmonary gas exchange was achieved with CMV and HFV, and the efficiency of oxygenation, that is, (A-a)DO2, was similar in the two conditions. During HFV, the lung volume was higher than during CMV in most patients. Muscle paralysis did not significantly change either PaCO2 or PaO2. In general, increasing fresh gas flow into the HFV system above approximately 10 1/min resulted in little reduction in PaCO2, but reduction of fresh gas flow below approximately 6 1/min increased PaCO2 progressively. Currently, we do not recommend HFV at 12-18 Hz for routine use during anesthesia for orthopedic or abdominal surgery.
对67例接受各种外科手术麻醉的患者，比较了常规机械通气（CMV）（潮气量10 ml/kg，频率8 - 10次/分钟）与高频小容量通气（HFV）期间的肺气体交换情况。研究了在振荡频率为3至18 Hz、潮气量为0.8至2.2 ml/kg的情况下的HFV。CMV和HFV均实现了足够的肺气体交换，且两种情况下的氧合效率，即（A-a）DO2相似。在HFV期间，大多数患者的肺容积高于CMV期间。肌肉麻痹对PaCO2或PaO2均无显著影响。一般来说，将进入HFV系统的新鲜气体流量增加到约10 l/min以上，PaCO2降低很少，但将新鲜气体流量降低到约6 l/min以下会使PaCO2逐渐升高。目前，我们不建议在骨科或腹部手术麻醉期间常规使用12 - 18 Hz的HFV。
