Different high-frequency ventilator strategies: effect on the propagation of tracheobronchial histopathologic changes

To assess the role of high-frequency ventilator strategy in the propagation of airway injury, we compared the tracheobronchial histologic alterations in 20 newborn piglets ventilated for 8 hours with high-frequency flow interruption (HFFI). Ten animals were assigned to HFFI with a strategy of contin...

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 1990, Vol.85 (1), p.70-78
Main Authors: WISWELL, T. E, BLEY, J. A, TURNER, B. S, HUNT, R. E, FRITZ, D. L
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Biological and medical sciences
Bronchi - injuries
Bronchi - pathology
Bronchi - ultrastructure
Emergency and intensive respiratory care
Epithelium - pathology
Female
High-Frequency Ventilation - adverse effects
Intensive care medicine
Male
Medical sciences
Microscopy, Electron, Scanning
Swine
Trachea - injuries
Trachea - pathology
Trachea - ultrastructure
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To assess the role of high-frequency ventilator strategy in the propagation of airway injury, we compared the tracheobronchial histologic alterations in 20 newborn piglets ventilated for 8 hours with high-frequency flow interruption (HFFI). Ten animals were assigned to HFFI with a strategy of continuous pulsations at a frequency of 10 Hz and a mean airway pressure of 16 cm H2O. Ten piglets were treated at identical settings except for 10 one-second baseline pauses per minute to a positive end-expiratory pressure of 5 cm H2O. A semiquantitative scoring system was used to grade light microscopic tissue alterations in the trachea, carina, and mainstem bronchi. Ultrastructural changes were evaluated with scanning electron microscopy. The HFFI-continuous-treated piglets had significantly more damage in all areas than the HFFI-baseline pause group (P less than .001). The upper tracheas of animals in both groups were altered to a greater extent than the lower tracheas (P less than .007). In addition, numerous "skip" areas of injury were noted throughout the tracheas. High-frequency ventilator strategy is a determinant of the severity of airway histologic changes. Factors that adversely affect tissue oxygenation or cause direct mechanical trauma may also influence the degree of injury. Optimal operating characteristics and limitations of different high-frequency devices must be assessed before their use in human neonates.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.85.1.70