原创力文档high-frequency oscillatory ventilation and pediatric cardiac surgery yes, we can!高频振荡通气和小儿心脏手术是的,我们可以!.pdfVIP
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high-frequency oscillatory ventilation and pediatric cardiac surgery yes, we can!高频振荡通气和小儿心脏手术是的,我们可以!
Kneyber Critical Care 2011, 15:1011
/content/15/6/1011
COMMENTARY
High-frequency oscillatory ventilation and
pediatric cardiac surgery: Yes, we can!
Martin CJ Kneyber*
See related research by Bojan et al., /content/15/5/R259
High-frequency oscillatory ventilation (HFOV), as used
Abstract by Bojan and colleagues, is, at least in theory, an ideal
In the previous issue of Critical Care, Bojan and tool for lung-protective ventilation as it allows eff ective
colleagues reported their experiences with high- pulmonary gas exchange with the delivery of a very small
frequency oscillatory ventilation (HFOV) after pediatric tidal volume (VT) below dead space and diminished risk
cardiac surgery. A total of 120 patients were treated of atelectrauma [1,2]. Numerous animal and clinical
with HFOV on the day of surgery, thus excluding rescue studies have shown clearly that mechanical ventilation
HFOV use. The main i nding of the authors was that (MV) itself can initiate or exacerbate lung injury, termed
the duration of mechanical ventilation was signii cantly ventilator-induced lung injury. h e application of a VT
shorter in patients in whom HFOV was initiated on the and the repetitive opening and closure of alveoli have
day of surgery. Especially interesting about this work is been identifi ed as important pathophysiological mecha-
that the authors used HFOV when there was evidence nisms [3].
of pulmonary hypertension or right ventricular (RV) Until now, only
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