Tracheal and bronchial injury in high-frequency oscillatory ventilation and high-frequency flow interruption compared with conventional positive-pressure ventilation

Thomas E. Wiswell, Reese H. Clark, Donald M. Null, Thomas J. Kuehl, Robert A. deLemos, Jacqueline J. Coalson

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

We compared the histopathologic changes in the alrways of premature baboons treated with conventional positive-pressure ventilation (PPV) with those seen after high-frequency oscillatory ventilation (HFOV) and high-frequency flow interruption (HFFI). Twenty-six animals were treated with ventilation for 24 hours (five PPV, 10 HFOV, 11 HFFI), and 18 were treated with ventilation for 96 hours (six PPV, six HFOV, six HFFI). A semiquantitative scoring system was used to grade tissue changes in the trachea, carina, and both main-stem bronchi. Alterations were produced by all forms of mechanical ventilation. The degree of injury was similar and relatively mild for the PPV- and HFOV-treated animals at both 24 and 96 hours. Eleven of 17 baboons treated with HFFI ventilation (8/11 at 24 hours; 3/6 at 96 hours) had severe airway damage characterized by diffuse submucosal necrosis, extensive hemorrhage, dense polymorphonuclear leukocyte infiltration, sloughed epithelium, focal basophilia, and intraluminal debris. HFOV resulted in no greater degree of airway damage than did PPV. The use of HFFI, with the particular strategy we employed, resulted in a far greater degree of damage than either PPV (P<0.01) or HFOV (P<0.01).

Original languageEnglish (US)
Pages (from-to)249-256
Number of pages8
JournalThe Journal of Pediatrics
Volume112
Issue number2
DOIs
StatePublished - 1988
Externally publishedYes

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High-Frequency Ventilation
Positive-Pressure Respiration
Wounds and Injuries
Ventilation
Papio
Bronchi
Trachea
Artificial Respiration
Neutrophils
Necrosis
Epithelium
Hemorrhage

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Tracheal and bronchial injury in high-frequency oscillatory ventilation and high-frequency flow interruption compared with conventional positive-pressure ventilation. / Wiswell, Thomas E.; Clark, Reese H.; Null, Donald M.; Kuehl, Thomas J.; deLemos, Robert A.; Coalson, Jacqueline J.

In: The Journal of Pediatrics, Vol. 112, No. 2, 1988, p. 249-256.

Research output: Contribution to journalArticle

Wiswell, Thomas E. ; Clark, Reese H. ; Null, Donald M. ; Kuehl, Thomas J. ; deLemos, Robert A. ; Coalson, Jacqueline J. / Tracheal and bronchial injury in high-frequency oscillatory ventilation and high-frequency flow interruption compared with conventional positive-pressure ventilation. In: The Journal of Pediatrics. 1988 ; Vol. 112, No. 2. pp. 249-256.
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