High Frequency Oscillatory Ventilation in ARDS

ARDS 中的高频振荡通气

• 批准号: 6988477
• 负责人: DAVID N HAGER
• 金额: $ 4.51万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-16 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6988477
• 关键词: adult respiratory distress syndrome; carbon dioxide tension; clinical research; clinical trials; high frequency ventilation; human subject; human therapy evaluation; mathematical model; model design /development; nonblood rheology; outcomes research; patient oriented research; postdoctoral investigator; respiratory airway pressure; respiratory airway volume; therapy design /development

DESCRIPTION (provided by applicant): Acute respiratory distress syndrome (ARDS) affects 100,000-200,000 persons per year in the United States. The large majority of these patients require mechanical ventilation (MV) for survival. However, MV may exacerbate lung injury and delay or prevent recovery from otherwise treatable conditions such as trauma, sepsis, & pneumonia. Several "lung protective" strategies have been examined to limit this ventilator-associated injury (VALI). The use of conventional ventilation with low tidal volumes (Vt) and inspiratory pressure limitation has lead to improved outcomes when compared to more traditional approaches. However, the degree to which Vt can be reduced and still maintain adequate oxygenation and ventilation is limited. An alternative lung protective strategy is high frequency oscillatory ventilation (HFOV), which uses very small Vts at high frequency to achieve effective oxygenation and ventilation. However, little is known about the use of HFOV in adult patients with ARDS. Though a series of small observational studies and one randomized controlled trial suggest that HFOV can be safely administered to patients with ARDS, the physiologic responses to changes in ventilator settings are not well understood. The projects described in this application are designed to establish these relationships so that an efficient and effective protocol may be designed for the comparison of HFOV to the present standard of care among patients ventilated for ARDS.

描述（由申请人提供）：在美国，急性呼吸窘迫综合征（ARDS）每年影响10万至20万人。 这些患者中的大多数需要机械通气（MV）才能生存。然而，MV可能会加重肺损伤，延迟或阻止从其他可治疗的疾病（如创伤，败血症和肺炎）中恢复。已经研究了几种“肺保护”策略来限制这种呼吸机相关损伤（VALI）。与更传统的方法相比，使用低潮气量（Vt）和吸气压力限制的常规通气可改善结局。 然而，Vt可以降低并仍然保持足够的氧合和通气的程度是有限的。另一种肺保护策略是高频振荡通气（HFOV），其在高频下使用非常小的Vt来实现有效的氧合和通气。然而，对成人ARDS患者使用HFOV知之甚少。尽管一系列小型观察性研究和一项随机对照试验表明，HFOV可以安全地用于ARDS患者，但对呼吸机设置变化的生理反应尚未得到充分了解。本申请中描述的项目旨在建立这些关系，以便可以设计高效且有效的方案，用于在因ARDS而通气的患者中将HFOV与当前护理标准进行比较。