Diferencia entre revisiones de «High frequency oscillation ventilation»

Revisión del 18:50 22 jun 2016

High Frequency Oscillation Ventilation (HFOV) is an alternative method for mechanical ventilation in difficult to oxygenate in critically ill ARDS patients.
Studied in patients with PaO2/FiO2 < 200
See Oscillate trial

Ventilator protocol from the Oscillate trial

Recruitment maneuver of 40 cmH2O PEEP for 40 seconds
Initiate high frequency ventilation -> 3-15Hz
- I:E time of 1:2
VT minimized to keep pH >7.25
- Goal of 1-4 ml/Kg
Maitain mean airway pressure of 30 cmH2O with pressure adjusted to maintain a PaO2 of 55-80 mmHg
Reversion to standard ventilation of mean airway pressure was ≤24 cmH2O for 12 hours or anytime when ≤20 cmH2O
Re-initiation of HFOV if FIO2 >0.4 or PEEP >14 cmH2O for >1 hour in the subsequent 48 hours

Low tidal volumes
Delivered at high frequency
Maintains lung recruitment
- Reduces Ventilator Induced Lung Injury (VILI) from recruitment and de-recruitment

Authors:

@@ Línea 1: / Línea 1: @@
 ===Background===
-High Frequency Oscillation Ventilation (HFOV) is an alternative method for ventilation and oxygenation in critically ill patients.
+*High Frequency Oscillation Ventilation (HFOV) is an alternative method for mechanical ventilation in difficult to oxygenate in critically ill ARDS patients.
+*Studied in patients with PaO2/FiO2 < 200
+* See [https://www.wikijournalclub.org/wiki/OSCILLATE Oscillate] trial
+===Procedure===
+''Ventilator protocol from the Oscillate trial''
+*Recruitment maneuver of 40 cmH2O PEEP for 40 seconds
+*Initiate high frequency ventilation -> 3-15Hz
+**I:E time of 1:2
+*VT minimized to keep pH >7.25
+**Goal of 1-4 ml/Kg
+*Maitain mean airway pressure of 30 cmH2O with pressure adjusted to maintain a PaO2 of 55-80 mmHg
+*Reversion to standard ventilation of mean airway pressure was ≤24 cmH2O for 12 hours or anytime when ≤20 cmH2O
+*Re-initiation of HFOV if FIO2 >0.4 or PEEP >14 cmH2O for >1 hour in the subsequent 48 hours
 ===Mechanism===