Hemodynamic Changes During High Frequency Oscillatory Ventilation in Newborn Piglets with Respiratory Distress Syndrome

• Author / Creator

  Bhogal, Jagmeet

• Respiratory failure is common in critically ill neonates, with refractory cases often needing high frequency oscillatory ventilation (HFOV). Volume guarantee mode has been added to some HFOV ventilators for theoretical better maintenance of normocapnia. There is little information on the systemic and regional hemodynamic effects of HFOV and this additional modality. We modified an established acute model of moderate-severe respiratory distress syndrome induced by saline lavage over 45-60 minutes in newborn piglets and compared ventilatory modes of HFOV with and without volume guarantee, and conventional mechanical ventilation. Using a randomized controlled approach based on the ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments), we compared the systemic and cerebral hemodynamic parameters in newborn piglets with severe respiratory failure (alveolar arterial oxygen gradient > 350 mmHg) using ultrasonic flow probes and near-infrared spectroscopy probes. They were ventilated over a total period of 4 hours with HFOV with and without volume guarantee or conventional mechanical ventilation (n=8 per group), whereas 6 sham-operated piglets were instrumented as normoxic references. We found that HFOV with volume guarantee had no effect on cardiac index (primary outcome), a positive effect on left ventricular contractility, and a negative effect on both cerebral perfusion and oxygenation. The left ventricular cardiac index, PaCO2, and pH were also lower, higher, and lower, respectively, over time in the CMV group. Further translational and clinical studies are needed to confirm our findings.

• Subjects / Keywords

  • neonate
  • newborn
  • volume guarantee
  • high frequency oscillatory ventilation
  • hemodynamic
  • respiratory distress syndrome
  • piglet

• Graduation date

  Fall 2019

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-8hwh-nm14

• License

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