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Table of Contents
Vol. 101, No. 4, 2012
Issue release date: June 2012
Section title: Original Paper
Neonatology 2012;101:267–273
(DOI:10.1159/000334828)

Impact of Conventional Breath Inspiratory Time during High-Frequency Jet Ventilation in Preterm Lambs

Musk G.C.a · Polglase G.R.a, c · Song Y.a, b · Pillow J.J.a, b, d
aSchool of Women’s and Infants’ Health and bCentre for Neonatal Research and Education, The University of Western Australia, Crawley, W.A., cRitchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash Medical Centre, Clayton, Vic., and dNCCU, King Edward Memorial and Princess Margaret Hospitals, Subiaco, W.A., Australia

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 05, 2011
Accepted: October 31, 2011
Published online: January 14, 2012
Issue release date: June 2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Background: Conventional mechanical ventilator (CMV) breaths during high-frequency jet ventilation (HFJV) are advocated to recruit and stabilize alveoli. Objectives: To establish if CMV breath duration delivered during HFJV influences gas exchange, lung mechanics and lung injury. Methods: Preterm lambs at 128 days gestational age were studied. HFJV (7 Hz, PEEP 8 cm H2O, PIPHFJV 40 cm H2O, FiO2 0.4) with superimposed CMV breaths (PIPCMV 25 cm H2O, rate 5 breaths/min) was commenced after delivery and continued for 2 h. CMV breath inspiratory time (tI) was either 0.5 s (HFJV+CMV0.5; n = 8) or 2.0 s (HFJV+CMV2.0; n = 8). Age-matched unventilated controls (UVC) were included for comparison. Results: Serial arterial blood gas analyses were performed. PIPHFJV was adjusted to target a PaCO2 of 45–55 mm Hg. FiO2 was adjusted to target SpO2 90–95%. Pressure-volume curves, broncho-alveolar lavage (BAL) and lung tissue samples were obtained postmortem. Gas exchange, ventilation parameters, static lung compliance and BAL inflammatory markers were not different between HFJV+CMV0.5 and HFJV+CMV2.0. Both ventilation groups had higher BAL inflammatory markers and increased iNOS-positive cells on histology compared to UVC, whilst lung tissue IL-1β and IL-6 mRNA expression was higher in the HFJV+CMV2.0 group compared to the UVC group. Conclusions: Preterm lambs were ventilated effectively with HFJV and 5 CMV breaths/min. CMV breath duration did not alter blood gas exchange, ventilation parameters, ex vivo static lung mechanics or markers of lung injury over a 2-hour study, although consistent trends towards increased inflammatory markers with the longer tI suggest greater risk of injury.

© 2012 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: May 05, 2011
Accepted: October 31, 2011
Published online: January 14, 2012
Issue release date: June 2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.