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Hemodynamic Changes During High Frequency Oscillatory Ventilation in Newborn Piglets with Respiratory Distress Syndrome

  • Author / Creator
    Bhogal, Jagmeet
  • Respiratory failure is common in critically ill neonates, with refractory cases often needing high frequency oscillatory ventilation (HFOV). Volume guarantee mode has been added to some HFOV ventilators for theoretical better maintenance of normocapnia. There is little information on the systemic and regional hemodynamic effects of HFOV and this additional modality. We modified an established acute model of moderate-severe respiratory distress syndrome induced by saline lavage over 45-60 minutes in newborn piglets and compared ventilatory modes of HFOV with and without volume guarantee, and conventional mechanical ventilation. Using a randomized controlled approach based on the ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments), we compared the systemic and cerebral hemodynamic parameters in newborn piglets with severe respiratory failure (alveolar arterial oxygen gradient > 350 mmHg) using ultrasonic flow probes and near-infrared spectroscopy probes. They were ventilated over a total period of 4 hours with HFOV with and without volume guarantee or conventional mechanical ventilation (n=8 per group), whereas 6 sham-operated piglets were instrumented as normoxic references. We found that HFOV with volume guarantee had no effect on cardiac index (primary outcome), a positive effect on left ventricular contractility, and a negative effect on both cerebral perfusion and oxygenation. The left ventricular cardiac index, PaCO2, and pH were also lower, higher, and lower, respectively, over time in the CMV group. Further translational and clinical studies are needed to confirm our findings.

  • Subjects / Keywords
  • Graduation date
    Fall 2019
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/r3-8hwh-nm14
  • License
    Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.