Scientific article
Open access

Expiratory high-frequency percussive ventilation: a novel concept for improving gas exchange

Published inRespiratory research, vol. 23, no. 1, 283
Publication date2022-10-15
First online date2022-10-15

Background: Although high-frequency percussive ventilation (HFPV) improves gas exchange, concerns remain about tissue overdistension caused by the oscillations and consequent lung damage. We compared a modified percussive ventilation modality created by superimposing high-frequency oscillations to the conventional ventilation waveform during expiration only (eHFPV) with conventional mechanical ventilation (CMV) and standard HFPV.

Methods: Hypoxia and hypercapnia were induced by decreasing the frequency of CMV in New Zealand White rabbits (n = 10). Following steady-state CMV periods, percussive modalities with oscillations randomly introduced to the entire breathing cycle (HFPV) or to the expiratory phase alone (eHFPV) with varying amplitudes (2 or 4 cmH2O) and frequencies were used (5 or 10 Hz). The arterial partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2) were determined. Volumetric capnography was used to evaluate the ventilation dead space fraction, phase 2 slope, and minute elimination of CO2. Respiratory mechanics were characterized by forced oscillations.

Results: The use of eHFPV with 5 Hz superimposed oscillation frequency and an amplitude of 4 cmH2O enhanced gas exchange similar to those observed after HFPV. These improvements in PaO2 (47.3 ± 5.5 vs. 58.6 ± 7.2 mmHg) and PaCO2 (54.7 ± 2.3 vs. 50.1 ± 2.9 mmHg) were associated with lower ventilation dead space and capnogram phase 2 slope, as well as enhanced minute CO2 elimination without altering respiratory mechanics.

Conclusions: These findings demonstrated improved gas exchange using eHFPV as a novel mechanical ventilation modality that combines the benefits of conventional and small-amplitude high-frequency oscillatory ventilation, owing to improved longitudinal gas transport rather than increased lung surface area available for gas exchange.

  • Alveolar recruitment
  • Blood gas
  • Capnography
  • Gas exchange
  • Lung ventilation
  • Animals
  • Carbon Dioxide
  • Cytomegalovirus Infections
  • High-Frequency Ventilation
  • Oxygen
  • Pulmonary Gas Exchange
  • Rabbits
  • Respiration, Artificial
  • Hungarian Science Foundation - [OTKA-NKFIH K138032]
Citation (ISO format)
PETAK, Ferenc et al. Expiratory high-frequency percussive ventilation: a novel concept for improving gas exchange. In: Respiratory research, 2022, vol. 23, n° 1, p. 283. doi: 10.1186/s12931-022-02215-2
Main files (1)
Article (Published version)
Secondary files (1)
ISSN of the journal1465-9921

Technical informations

Creation11/15/2022 11:46:40 AM
First validation05/16/2023 6:36:52 PM
Update time05/16/2023 6:36:52 PM
Status update05/16/2023 6:36:52 PM
Last indexation08/31/2023 11:13:36 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack