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Research ArticleOriginal Research

High-Frequency Percussive Ventilation: Pneumotachograph Validation and Tidal Volume Analysis

Patrick F Allan
Respiratory Care June 2010, 55 (6) 734-740;
Patrick F Allan
Pulmonary Medicine Service, Landstuhl Regional Medical Center, Landstuhl, Germany.
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Abstract

INTRODUCTION: High-frequency percussive ventilation (HFPV) is an increasingly used mode of mechanical ventilation, for which there is no proven real-time means of measuring delivered tidal volume (VT).

OBJECTIVE: To validate a pneumotachograph for HFPV and then exploit flow-sensor data to describe the behavior of both low-frequency and high-frequency breaths.

METHODS: Sensor performance was gauged during changes in high-frequency (4–12 Hz) and low-frequency rate and ratio, mean airway pressure, oxygen concentration, heated or heated-humidified gas flow, and endotracheal tube diameter. Glass bottle (adiabatic VT) and test lung (adiabatically derived low-frequency VT) based adiabatic conditions provided both an initial source for analog-signal calibration and an accepted standard comparator to flow-sensor measurement of high-frequency and low-frequency (flow-sensor-derived) VT), respectively.

RESULTS: Pneumotachography proved accurate and precise over an array of tested settings and conditions when analyzing both high-frequency (difference between mean ± SD high-frequency VT and adiabatic VT was –0.2 ± 1.8%, 95% confidence interval –0.5 to 0.9%) and low-frequency breaths (mean ± SD difference between flow-sensor-derived low-frequency VT and adiabatically derived low-frequency VT was 0.6 ± 2.4%, 95% confidence interval 0.1–1.1%). High-frequency VT and frequency exhibited an exponential relationship. During HFPV, flow-sensor-derived low-frequency VT had a mean ± SD of 1,337 ± 700 mL, 95% confidence interval 1,175–1,499 mL.

CONCLUSIONS: Readily available pneumotachography provided accurate measurements of low-frequency and high-frequency VT during HFPV. In the setting of acute lung injury, typical HFPV settings may deliver injurious VT.

  • high-frequency percussive ventilation
  • HFPV
  • mechanical ventilation
  • tidal volume
  • VT
  • pneumotachography

Footnotes

  • Correspondence: Patrick F Allan MD, Pulmonary Medicine Service, Landstuhl Regional Medical Center, CMR 402, Box 307, APO AE 09180, Landstuhl, Germany. E-mail: patrick.allan{at}amedd.army.mil.
  • The opinions and assertions in this paper are the private views of the author and are not to be construed as reflecting the views of the United States Department of the Air Force or the Department of Defense.

  • The author has disclosed no conflicts of interest.

  • Copyright © 2010 by Daedalus Enterprises Inc.
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Respiratory Care: 55 (6)
Respiratory Care
Vol. 55, Issue 6
1 Jun 2010
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High-Frequency Percussive Ventilation: Pneumotachograph Validation and Tidal Volume Analysis
Patrick F Allan
Respiratory Care Jun 2010, 55 (6) 734-740;

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High-Frequency Percussive Ventilation: Pneumotachograph Validation and Tidal Volume Analysis
Patrick F Allan
Respiratory Care Jun 2010, 55 (6) 734-740;
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Keywords

  • high-frequency percussive ventilation
  • HFPV
  • mechanical ventilation
  • tidal volume
  • VT
  • pneumotachography

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