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. 2022 May 16:1–5. Online ahead of print. doi: 10.1007/s12204-022-2424-7

Gas Exchange Mechanism of High Frequency Ventilation: A Brief Narrative Review and Prospect

Yueyang Yuan 1,✉, Yuqing Chen 2, Li Zhou 1, Wei Liu 3, Zheng Dai 3
PMCID: PMC9109743  PMID: 35600242

Abstract

The high frequency ventilation (HFV) can well support the breathing of respiratory patient with 20%–40% of normal tidal volume. Now as a therapy of rescue ventilation when conversional ventilation failed, the HFV has been applied in the treatments of severe patients with acute respiratory failure (ARF), acute respiratory distress syndrome (ARDS), etc. However, the gas exchange mechanism (GEM) of HFV is still not fully understood by researchers. In this paper, the GEM of HFV is reviewed to track the studies in last decades and prospect for the next likely studies. And inspired by previous studies, the GEM of HFV is suggested to be continually developed with various hypotheses which will be testified in simulation, experiment and clinic trail. One of the significant measures is to study the GEM of HFV under the cross-disciplinary integration of medicine and engineering. Fully understanding the GEM can theoretically support and expand the applications of HFV, and is helpful in investigating the potential indications and contraindications of HFV.

Key words: mechanical ventilation, high frequency ventilation, gas exchange mechanisms

Foundation item

the Natural Science Foundation of Hunan, China (No. 2020JJ4159), the Research Foundation of Education Bureau of Hunan, China (No. 19A093), the Interdisciplinary Program of Shanghai Jiao Tong University (No. YG2019ZDB08), and the Significant Special Project form Ministry of Science and Technology of China (No. 2021YFC0122500)

References

  • [1].Poor H. Basics of mechanical ventilation [M] Cham: Springer; 2018. pp. 29–38. [Google Scholar]
  • [2].Harris C, Thorpe S D, Rushwan S, et al. An in vitro investigation of the inflammatory response to the strain amplitudes which occur during high frequency oscillation ventilation and conventional mechanical ventilation [J] Journal of Biomechanics. 2019;88:186–189. doi: 10.1016/j.jbiomech.2019.03.024. [DOI] [PubMed] [Google Scholar]
  • [3].Roth C J, Förster K M, Hilgendorff A, et al. Gas exchange mechanisms in preterm infants on HFOV: A computational approach [J] Scientific Reports. 2018;8:13008. doi: 10.1038/s41598-018-30830-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [4].Ng J, Ferguson N D. High-frequency oscillatory ventilation: Still a role? [J] Current Opinion in Critical Care. 2017;23(2):175–179. doi: 10.1097/MCC.0000000000000387. [DOI] [PubMed] [Google Scholar]
  • [5].Glau C L, Conlon T W, Himebauch A S, et al. Characterization of thoracic pathophysiologic conditions in patients receiving high-frequency oscillatory ventilation: Pediatric experience [J] Journal of Ultrasound in Medicine. 2018;37(10):2425–2431. doi: 10.1002/jum.14600. [DOI] [PubMed] [Google Scholar]
  • [6].Sklar M C, Fan E, Goligher E C. High-frequency oscillatory ventilation in adults with ARDS: Past, present, and future [J] Chest. 2017;152(6):1306–1317. doi: 10.1016/j.chest.2017.06.025. [DOI] [PubMed] [Google Scholar]
  • [7].Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: A narrative review [J] Canadian Journal of Respiratory Therapy. 2019;55:40–46. doi: 10.29390/cjrt-2019-004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [8].Nguyen A P, Schmidt U H, Macintyre N R. Should high-frequency ventilation in the adult be abandoned? [J] Respiratory Care. 2016;61(6):791–800. doi: 10.4187/respcare.04584. [DOI] [PubMed] [Google Scholar]
  • [9].Kaczka D W. Oscillatory ventilation redux: Alternative perspectives on ventilator-induced lung injury in the acute respiratory distress syndrome [J] Current Opinion in Physiology. 2021;21:36–43. doi: 10.1016/j.cophys.2021.03.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [10].Godet T, Jabaudon M, Blondonnet R, et al. High frequency percussive ventilation increases alveolar recruitment in early acute respiratory distress syndrome: An experimental, physiological and CT scan study [J] Critical Care. 2018;22(1):3. doi: 10.1186/s13054-017-1924-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [11].He M Y, Lin X Z. Research advances in the methods for weaning from high-frequency oscillatory ventilation in neonates [J] Chinese Journal of Contemporary Pediatrics. 2019;21(12):1234–1239. doi: 10.7499/j.issn.1008-8830.2019.12.016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [12].Zannin E, Dellaca’ R L, Dognini G, et al. Effect of frequency on pressure cost of ventilation and gas exchange in newborns receiving high-frequency oscillatory ventilation [J] Pediatric Research. 2017;82(6):994–999. doi: 10.1038/pr.2017.151. [DOI] [PubMed] [Google Scholar]
  • [13].Bansal N, Chauhan A S, Menon R P. A learning experience in the use of high-frequency oscillatory ventilation in infants post-cardiac surgery [J] Indian Journal of Thoracic and Cardiovascular Surgery. 2019;35(2):257–258. doi: 10.1007/s12055-018-0772-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [14].Xiang Y, Zeng L, Luo T, et al. Risk factors for hypoxemia after coronary artery bypass grafting: A systematic review and meta-analysis [J] Chinese Journal of Clinical Thoracic and Cardiovascular Surgery. 2020;27(8):926–932. [Google Scholar]
  • [15].González-Pacheco N, Sánchez-Luna M, Chimenti-Camacho P, et al. Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury [J] Journal of Perinatology. 2019;39(5):730–736. doi: 10.1038/s41372-019-0338-5. [DOI] [PubMed] [Google Scholar]
  • [16].Lai J, Du L, Xiong G, et al. Clinical epidemiological characteristics of neonatal respiratory failure: An analysis of 1108 neonates [J] Chinese Journal of Contemporary Pediatrics. 2016;18(1):10–14. doi: 10.7499/j.issn.1008-8830.2016.01.003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [17].Petrillo F, Gizzi C, Maffei G, et al. Neonatal respiratory support strategies for the management of extremely low gestational age infants: An Italian survey [J] Italian Journal of Pediatrics. 2019;45(1):44. doi: 10.1186/s13052-019-0639-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [18].Courtney S E, Durand D J, Asselin J M, et al. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants [J] The New England Journal of Medicine. 2002;347(9):643–652. doi: 10.1056/NEJMoa012750. [DOI] [PubMed] [Google Scholar]
  • [19].Diehl J L, Peron N, Chocron R, et al. Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: A hypothesis-generating study [J] Annals of Intensive Care. 2020;10(1):95. doi: 10.1186/s13613-020-00716-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [20].Gu J Y, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission [J] Gastroenterology. 2020;158(6):1518–1519. doi: 10.1053/j.gastro.2020.02.054. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [21].Luo M, Ni K, Wen K, et al. Biomechanical issues of mechanical ventilation in Covid-19 therapy [J] Journal of Medical Biomechanics. 2020;35(3):265–270. [Google Scholar]
  • [22].Chen Y, Li W. The clinical symptoms, classification and diagnosis of COVID-19 [J] Genomics and Applied Biology. 2020;39(8):3904–3907. [Google Scholar]
  • [23].Guan W J, Ni Z Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China [J] New England Journal of Medicine. 2020;382(18):1708–1720. doi: 10.1056/NEJMoa2002032. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [24].Pillow J J. High-frequency oscillatory ventilation: Mechanisms of gas exchange and lung mechanics [J] Critical Care Medicine. 2005;33(3):S135–S141. doi: 10.1097/01.CCM.0000155789.52984.B7. [DOI] [PubMed] [Google Scholar]
  • [25].Yuan Y, Zhou L, Liu W, et al. Prospects and developments in the technologies of high frequency oscillatory ventilation [J] Journal of Biomedical Engineering. 2021;38(1):185–190. doi: 10.7507/1001-5515.202003072. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [26].Chang H K. Mechanisms of gas transport during ventilation by high-frequency oscillation [J] Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology. 1984;56(3):553–563. doi: 10.1152/jappl.1984.56.3.553. [DOI] [PubMed] [Google Scholar]
  • [27].Fletcher P R, Epstein R A. Constancy of physiological dead space during high-frequency ventilation [J] Respiration Physiology. 1982;47(1):39–49. doi: 10.1016/0034-5687(82)90091-3. [DOI] [PubMed] [Google Scholar]
  • [28].Scherer P W, Haselton F R. Convective exchange in oscillatory flow through bronchial-tree models [J] Journal of Applied Physiology. 1982;53(4):1023–1033. doi: 10.1152/jappl.1982.53.4.1023. [DOI] [PubMed] [Google Scholar]
  • [29].Chang H K, El M O A. A model study of flow dynamics in human central airways. Part I: Axial velocity profiles [J] Respiration Physiology. 1982;49(1):75–95. doi: 10.1016/0034-5687(82)90104-9. [DOI] [PubMed] [Google Scholar]
  • [30].Otis A B, Mckerrow C B, Bartlett R A, et al. Mechanical factors in distribution of pulmonary ventilation [J] Journal of Applied Physiology. 1956;8(4):427–443. doi: 10.1152/jappl.1956.8.4.427. [DOI] [PubMed] [Google Scholar]
  • [31].Taylor G I. Diffusion and mass transport in tubes [J] Proceedings of the Physical Society Section B. 1954;67(12):857–869. doi: 10.1088/0370-1301/67/12/301. [DOI] [Google Scholar]
  • [32].Armengol J, Jones R L, King E G. Collateral ventilation during high-frequency oscillation in dogs [J] Journal of Applied Physiology. 1985;58(1):173–179. doi: 10.1152/jappl.1985.58.1.173. [DOI] [PubMed] [Google Scholar]
  • [33].Lee W J, Kawahashi M, Hirahara H. Experimental analysis of pendelluft flow generated by HFOV in a human airway model [J] Physiological Measurement. 2006;27(8):661–674. doi: 10.1088/0967-3334/27/8/001. [DOI] [PubMed] [Google Scholar]
  • [34].Greenblatt E E, Butler J P, Venegas J G, et al. Pendelluft in the bronchial tree [J] Journal of Applied Physiology. 2014;117(9):979–988. doi: 10.1152/japplphysiol.00466.2014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [35].Yuan Y Y, Yang C C, Li Z, et al. Oscillatory flow of HFV distributed in left and right lungs: A model-based experiment and investigation [J] Journal of Mechanics in Medicine and Biology. 2014;14(6):1440015. doi: 10.1142/S0219519414400156. [DOI] [Google Scholar]
  • [36].Yuan Y Y, Chen Y Q, Xiao H, et al. Investigating the mechanism of the high frequency ventilation for the oscillation airflow between left and right lungs [J] Journal of Biomedical Engineering. 2019;36(3):393–400. doi: 10.7507/1001-5515.201810003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [37].Jacob C, Tingay D, Leontini J. The role of mean streaming and turbulent mixing for gas transport during high-frequency ventilation [C]; Melbourne: Engineers Australia; 2019. pp. 57–60. [Google Scholar]
  • [38].Leontini J, Jacob C, Tingay D. Steady streaming and conditional turbulence in high-frequency ventilation [C]; Seattle: APS; 2019. p. 30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [39].González-Pacheco N, Sánchez-Luna M, Arribas-Sánchez C, et al. DCO2/PaCO2 correlation on high-frequency oscillatory ventilation combined with volume guarantee using increasing frequencies in an animal model [J] European Journal of Pediatrics. 2020;179(3):499–506. doi: 10.1007/s00431-019-03503-8. [DOI] [PubMed] [Google Scholar]

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