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High-frequency oscillatory ventilation: What large-animal studies have taught us!

Kacmarek, Robert M. PhD, RRT; Malhotra, Atul MD

doi: 10.1097/01.CCM.0000156786.43935.A0
Scientific Review

Background: Much of the information on the physiologic effects, mechanisms of gas exchange, and potential utility of high-frequency oscillation (HFO) has been acquired in animal studies. Specifically, large animal data have been useful in assessing adult application because large animals present many of the same concerns and challenges as adults.

Objective: To review the literature on HFO testing in large animal models, identifying contributions to the understanding of mechanisms of action and the physiology of HFO.

Results: Large animal studies have clarified the mechanisms of gas exchange during HFO, identified approaches to setting mean airway pressure based on lung mechanics, and identified a potentially better approach to applying partial liquid ventilation.

Conclusion: The study of HFO in large animal models has been essential to our understanding of the optimal approach to applying HFO in human studies.

From the Departments of Anesthesiology (RMK) and Medicine (AM), Harvard Medical School, Boston, MA; the Department of Respiratory Care, Massachusetts General Hospital, Boston, MA (RMK); and Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Boston, MA (AM).

© 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins