Comparison of flow and gas washout characteristics between pressure control and high-frequency percussive ventilation using a test lung.

Objective: A comparison between flow and gas washout data for high-frequency percussive ventilation (HFPV) and pressure control ventilation (PCV) under similar conditions is currently not available. This bench study aims to compare and describe the flow and gas washout behavior of HFPV and PCV in a newly designed experimental setup and establish a framework for future clinical and animal studies.

Approach: We studied gas washout behavior using a newly designed experimental setup that is motivated by the multi-breath nitrogen washout measurements. In this procedure, a test lung was filled with nitrogen gas before it was connected to a ventilator. Pressure, volume, and oxygen concentrations were recorded under different compliance and resistance conditions. PCV was compared with two settings of HFPV, namely, HFPV-High and HFPV-Low, to simulate the different variations in its clinical application. In the HFPV-Low mode, the peak pressures and drive pressures of HFPV and PCV are matched, whereas in the HFPV-High mode, the mean airway pressures (MAP) are matched.

Main Results: HFPV-Low mode delivers smaller tidal volume (V ) as compared to PCV under all lung conditions, whereas HFPV-High delivers a larger V . HFPV-High provides rapid washout as compared to PCV under all lung conditions. HFPV-Low takes a longer time to wash out nitrogen except at a low compliance, where it expedites washout at a smaller V and MAP compared to PCV washout.

Significance: Various flow parameters for HFPV and PCV are mathematically defined. A shorter washout time at a small V in low compliant test lungs for HFPV could be regarded as a hypothesis for lung protective ventilation for animal or human lungs.