Effect of high-frequency oscillation on blood flow to an atelectatic lung in closed-chest dogs.

Seven dogs with electromagnetic flow probes implanted on their main (QT) and left (QL) pulmonary arteries, had catheters placed in their left atria and pulmonary artery, and were ventilated via Carlen's double-lumen endotracheal tubes. The effect of high-frequency oscillation (HFO) on the redistribution of pulmonary blood flow away from unilaterally atelectatic lungs was determined. During bilateral ventilation with 100% O2, using either a Harvard respirator (PPV) or an Emerson airway vibrator (HFO), the fraction of cardiac output perfusing the left lung (QL/QT) was 0.45 +/- .01 and 0.43 +/- .01, respectively, whereas PaO2 was 465 +/- 40 and 334 +/- 34 torr, respectively. With left lung atelectasis during right lung ventilation with PPV at 10 to 15 cycle/min, QL/QT fell to 0.37 +/- .01 and PaO2 was 56 +/- 5 torr. During HFO at 100 cycle/min, QL/QT fell to 0.32 +/- .02 whereas PaO2 rose to 102 +/- 23 torr. Mean transpulmonary pressure was 10.0 +/- 1.5 torr with PPV and 7.3 +/- 1.2 torr during HFO; intrapleural pressures were -3.2 +/- 1.6 and -5.7 +/- 1.4 mm Hg, respectively. Thus, the diversion of blood away from unilaterally atelectatic lungs was better maintained during HFO.