High‐frequency oscillation versus conventional ventilation following surfactant administration and partial liquid ventilation

Surfactant followed by partial liquid ventilation (PLV) with perfluorocarbon (PFC; LiquiVent®) improves oxygenation, lung compliance, and lung pathology in lung‐injured animals receiving conventional ventilation (CV). In this study, we hypothesize that high‐frequency oscillation (HFO) and CV will provide equivalent oxygenation in lung‐injured animals following surfactant repletion and PLV, once lung volume is optimized. After saline‐lavage lung injury during CV, newborn piglets were randomized to either HFO (n = 10) or CV (n = 9). HFO animals were stabilized over 15 min without optimization of lung volume; CV animals continued treatment with time‐cycled, pressure‐limited, volume‐targeted ventilation. All animals then received 100 mg/kg of surfactant (Survanta®). Thirty minutes later, all received intratracheal PFC to approximate functional residual capacity. Thirty minutes after PLV began, mean airway pressure (MAP) in both groups was increased to improve oxygenation. MAP was directly adjusted during HFO; PEEP and PIP were adjusted during IMV, maintaining a pressure sufficient to deliver 15 mL/kg tidal volume. Animals were treated for 4 h.

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