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Presented at High Frequency Ventilation Conference, Snowbird Utah - April 4-9, 2000
"Low" frequency oscillation is potentially more injurious than "High" frequency oscillatory ventilation. Choong K, Chatrkraw P, Frndova H, et al. Toronto, Canada.
Using a rabbit lavage model of RDS, the investigators compared the effects of HFV at 5 and 15 Hz over a 4 hour period using the Sensormedics 3100A HFOV. On histological evaluation, the 5 Hz group had a greater accumulation of alveolar proteinaceous exudate (p=.002) and neutrophils (p=.015), and more sloughing of respiratory epithelium (p=.002).
Comment. Bearing in mind that tidal volume increases as frequency decreases on HFOV, these findings most likely represent volutrauma. To avoid this lung injury, it makes sense to use lower frequencies only when adequate ventilation cannot be achieved with other measures.
Andrew B. Kairalla MD