Gas transport mechanisms during high-frequency ventilation
Abstract By virtue of applying small tidal volumes, high-frequency ventilation is advocated as a method of minimizing ventilator-induced lung injury. Lung protective benefits are established in infants, but not in other patient cohorts. Efforts to improve and extend the lung protection potential sho...
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| Format: | Article |
| Language: | English |
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BMC
2024-12-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-024-03049-w |
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| author | Thomas J. A. Scott Chinthaka Jacob David G. Tingay Justin S. Leontini |
| author_facet | Thomas J. A. Scott Chinthaka Jacob David G. Tingay Justin S. Leontini |
| author_sort | Thomas J. A. Scott |
| collection | DOAJ |
| description | Abstract By virtue of applying small tidal volumes, high-frequency ventilation is advocated as a method of minimizing ventilator-induced lung injury. Lung protective benefits are established in infants, but not in other patient cohorts. Efforts to improve and extend the lung protection potential should consider how fundamental modes of gas transport can be exploited to minimize harmful tidal volumes while maintaining or improving ventilation. This research investigates different models of gas transport during high-frequency ventilation and discusses the extent to which the gas transport mechanisms are considered in each. The research focuses on the rationale for current ventilation protocols, how they were informed by these models, and investigates alternative protocols that may improve gas transport and lung protection. A review of high-frequency ventilation physiology and fluid mechanics literature was performed, and dimensional analyses were conducted showing the relationship between clinical data and the model outputs. We show that contemporary protocols have been informed by resistor-inductor-capacitor, or network, models of the airway-lung system that are formulated around a ventilation pressure cost framework. This framework leads to clinical protocol selection that ventilates patients at frequencies that excite a resonance in the lung. We extend on these models by considering frequencies that are much higher than resonance which further optimize gas transport in the airway via alternative gas transport mechanisms to bulk advection that operate for very low tidal volumes. Our findings suggest it is unlikely that gas transport is optimally exploited during current approaches to high-frequency ventilation and protocols that differ significantly from those currently in use could achieve ventilation while using very low tidal volumes. |
| format | Article |
| id | doaj-art-a4e59a0c7dab4a73b1fa795afeb986d0 |
| institution | Kabale University |
| issn | 1465-993X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj-art-a4e59a0c7dab4a73b1fa795afeb986d02024-12-29T12:42:11ZengBMCRespiratory Research1465-993X2024-12-0125111310.1186/s12931-024-03049-wGas transport mechanisms during high-frequency ventilationThomas J. A. Scott0Chinthaka Jacob1David G. Tingay2Justin S. Leontini3Department of Mechanical and Product Design Engineering, Swinburne University of TechnologyLaboratoire de Physique, ENSL, CNRSNeonatal Research, Murdoch Children’s Research InstituteDepartment of Mechanical and Product Design Engineering, Swinburne University of TechnologyAbstract By virtue of applying small tidal volumes, high-frequency ventilation is advocated as a method of minimizing ventilator-induced lung injury. Lung protective benefits are established in infants, but not in other patient cohorts. Efforts to improve and extend the lung protection potential should consider how fundamental modes of gas transport can be exploited to minimize harmful tidal volumes while maintaining or improving ventilation. This research investigates different models of gas transport during high-frequency ventilation and discusses the extent to which the gas transport mechanisms are considered in each. The research focuses on the rationale for current ventilation protocols, how they were informed by these models, and investigates alternative protocols that may improve gas transport and lung protection. A review of high-frequency ventilation physiology and fluid mechanics literature was performed, and dimensional analyses were conducted showing the relationship between clinical data and the model outputs. We show that contemporary protocols have been informed by resistor-inductor-capacitor, or network, models of the airway-lung system that are formulated around a ventilation pressure cost framework. This framework leads to clinical protocol selection that ventilates patients at frequencies that excite a resonance in the lung. We extend on these models by considering frequencies that are much higher than resonance which further optimize gas transport in the airway via alternative gas transport mechanisms to bulk advection that operate for very low tidal volumes. Our findings suggest it is unlikely that gas transport is optimally exploited during current approaches to high-frequency ventilation and protocols that differ significantly from those currently in use could achieve ventilation while using very low tidal volumes.https://doi.org/10.1186/s12931-024-03049-wHigh-frequency ventilationHigh-frequency oscillatory ventilationMechanical ventilationNonlinear mean streaming |
| spellingShingle | Thomas J. A. Scott Chinthaka Jacob David G. Tingay Justin S. Leontini Gas transport mechanisms during high-frequency ventilation Respiratory Research High-frequency ventilation High-frequency oscillatory ventilation Mechanical ventilation Nonlinear mean streaming |
| title | Gas transport mechanisms during high-frequency ventilation |
| title_full | Gas transport mechanisms during high-frequency ventilation |
| title_fullStr | Gas transport mechanisms during high-frequency ventilation |
| title_full_unstemmed | Gas transport mechanisms during high-frequency ventilation |
| title_short | Gas transport mechanisms during high-frequency ventilation |
| title_sort | gas transport mechanisms during high frequency ventilation |
| topic | High-frequency ventilation High-frequency oscillatory ventilation Mechanical ventilation Nonlinear mean streaming |
| url | https://doi.org/10.1186/s12931-024-03049-w |
| work_keys_str_mv | AT thomasjascott gastransportmechanismsduringhighfrequencyventilation AT chinthakajacob gastransportmechanismsduringhighfrequencyventilation AT davidgtingay gastransportmechanismsduringhighfrequencyventilation AT justinsleontini gastransportmechanismsduringhighfrequencyventilation |