Canadian respiratory journal · 2026
Acute Respiratory Distress Syndrome: Mechanical Ventilation vs. High-Frequency Percussive Ventilation.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Sagan Daniel, Parise Carol, Mohammed Imran, Mann Amandeep, Mohammed Mehreen, Alismail Abdullah
Аннотация
BACKGROUND: Studies that investigate the use of high-frequency percussive ventilation (HFPV) are scarce and outdated. HFPV is being used in some facilities primarily as a salvage modality on patients with acute respiratory distress syndrome (ARDS) when a conventional mechanical ventilator has failed to improve outcomes. There still are arguments whether HFPV is an effective ventilation strategy for adult patients with ARDS.
OBJECTIVES: The purpose of this study was to analyze and compare pulmonary gas exchange, as measured by arterial blood gas (ABG) values, between patients with ARDS who were transitioned from conventional mechanical ventilation to HFPV and those who remained on conventional mechanical ventilation.
METHODS: This was a retrospective study between 2016 and 2022. Data was extracted and analyzed from electronic medical records (EMRs) of ARDS patients. ABG results were analyzed from 12 to 2 h before, and 30 min, 2, 12, and 24 h after the initiation of conventional and HFPV. Continuous mandatory ventilation (CMV) settings were compared over 12 and 2 h before the initiation of HFPV and 2, 12, and 24 h after.
MEASUREMENTS AND MAIN RESULTS: A total of N = 351 cases were evaluated for this study (n1 = 194 in the CMV group and n2 = 157 in the HFPV group). Patients in the HFPV group had a lower mean baseline pH (7.25 vs. 7.34, p = <0.001) and higher PaCO2 (56.7 vs. 40.3 mmHg, p = <0.001) when compared to the CMV group. pH has increased and PaCO2 decreased quickly once HFPV was initiated. The mean baseline PaO2 was comparative (61.7 vs. 67.4 mmHg, p = 0.21) but the HFPV group had a more rapid and higher improvement compared to the CMV group (121.5 vs. 86.6, p = <0.001). Similarly, there was a significant improvement in the PF ratio after 12 h on HFPV (160.7 vs. 139.7, p = 0.03).
CONCLUSIONS: Results show that HFPV can effectively be used for adult ARDS as a salvage modality when a patient's ABG has become refractory to conventional mechanical ventilation.
OBJECTIVES: The purpose of this study was to analyze and compare pulmonary gas exchange, as measured by arterial blood gas (ABG) values, between patients with ARDS who were transitioned from conventional mechanical ventilation to HFPV and those who remained on conventional mechanical ventilation.
METHODS: This was a retrospective study between 2016 and 2022. Data was extracted and analyzed from electronic medical records (EMRs) of ARDS patients. ABG results were analyzed from 12 to 2 h before, and 30 min, 2, 12, and 24 h after the initiation of conventional and HFPV. Continuous mandatory ventilation (CMV) settings were compared over 12 and 2 h before the initiation of HFPV and 2, 12, and 24 h after.
MEASUREMENTS AND MAIN RESULTS: A total of N = 351 cases were evaluated for this study (n1 = 194 in the CMV group and n2 = 157 in the HFPV group). Patients in the HFPV group had a lower mean baseline pH (7.25 vs. 7.34, p = <0.001) and higher PaCO2 (56.7 vs. 40.3 mmHg, p = <0.001) when compared to the CMV group. pH has increased and PaCO2 decreased quickly once HFPV was initiated. The mean baseline PaO2 was comparative (61.7 vs. 67.4 mmHg, p = 0.21) but the HFPV group had a more rapid and higher improvement compared to the CMV group (121.5 vs. 86.6, p = <0.001). Similarly, there was a significant improvement in the PF ratio after 12 h on HFPV (160.7 vs. 139.7, p = 0.03).
CONCLUSIONS: Results show that HFPV can effectively be used for adult ARDS as a salvage modality when a patient's ABG has become refractory to conventional mechanical ventilation.