High-frequency Small-volume Ventilation in Anesthetized Humans

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Abstract
Pulmonary gas exchange during conventional mechanical ventilation (CMV) (tidal volume 10 ml/kg, rate 8-10 breaths/min) was compared with that during high-frequency small-volume ventilation (HFV) in 67 patients undergoing anesthesia for various surgical procedures. HFV was studied at oscillation frequencies ranging from 3-18 Hz with stroke volumes of 0.8-2.2 ml/kg. Adequate pulmonary gas exchange was achieved with CMV and HFV, and the efficiency of oxygenation, that is, (A-a)DO2, was similar in the 2 conditions. During HFV, the lung volume was higher than during CMV in most patients. Muscle paralysis did not significantly change either [arterial partial pressure] of PaO2. In general, increasing fresh gas flow into the HFV system above .apprx. 10 l/min resulted in little reduction in PaCO2, but reduction of fresh gas flow below .apprx. 6 l/min increased PaCO2 progressively. HFV at 12-18 Hz is not recommended for routine use during anesthesia for orthopedic or abdominal surgery.

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