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High Frequency Oscillation for Acute Respiratory Failure in Adults

  • S. D. Mentzelopoulos
  • C. Roussos
  • S. G. Zakynthinos

Abstract

In the acute respiratory distress Syndrome (ARDS), major mechanisms of ventilator-induced lung injury (VILI) include barotrauma, volutrauma, atelectrauma, and biotrauma [1, 2]. In an excellent review, Gattinoni et al. [2], argue that during conventional mechanical ventilation, lung stress and strain are the major determinants of VILI. Alveolar stress (i.e., transmural pressure) is the ratio of alveolar wall tension to thickness [3]. Overall lung parenchymal stress is reflected by plateau and peak transpulmonary pressures [1, 2]. Lung strain refers to the deformation of the lung parenchyma induced by the distending force applied by the ventilator. Strain is reflected by the tidal volume to end-expiratory lung volume ratio [3]. Early and severe ARDS is characterized by non-homogeneously distributed and frequently diffuse lung damage [4], with intra-alveolar and interstitial edema and hyaline membrane formation. The absolute reduction in ventilatable lung parenchyma supports the “baby lung” concept [5]. According to this simplified and theoretical description, the ARDS lung is “small but not stiff” [2, 5]. Consequently, the use of a high tidal volume should cause mechanical harm, ultimately resulting in increased mortality [2, 5, 6, 7, 8].

Keywords

Tidal Volume Airway Pressure Acute Respiratory Distress Syndrome Acute Respiratory Failure High Frequency Oscillatory 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • S. D. Mentzelopoulos
    • 1
  • C. Roussos
    • 1
  • S. G. Zakynthinos
    • 1
  1. 1.Intensive Care MedicineEvangelismos HospitalAthensGreece

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