TY - JOUR
T1 - Tracheal and bronchial injury in high-frequency oscillatory ventilation and high-frequency flow interruption compared with conventional positive-pressure ventilation
AU - Wiswell, Thomas E.
AU - Clark, Reese H.
AU - Null, Donald M.
AU - Kuehl, Thomas J.
AU - deLemos, Robert A.
AU - Coalson, Jacqueline J.
N1 - Funding Information:
We recently compared the tracheobronchial injury seen in premature baboons after 11 days of ventilation with either Supported in part by Grant HL 29354 from the National Heart, Lung, and Blood Institute. Submitted for publication May 4, 1987; accepted July 28, 1987. Reprint requests: Thomas E. Wiswell, MD, 7727 Iron Forge Court, Derwood, MD 20855. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army, the United States Air Force, or the Department of Defense.
PY - 1988/2
Y1 - 1988/2
N2 - 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).
AB - 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).
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U2 - 10.1016/S0022-3476(88)80065-9
DO - 10.1016/S0022-3476(88)80065-9
M3 - Article
C2 - 3276863
AN - SCOPUS:0023932311
VL - 112
SP - 249
EP - 256
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 2
ER -