Recent reports linking serious tracheal injuries to various forms of high-frequency ventilation prompted this study. We compared the tracheal histopathology seen following standard-frequency, conventional mechanical ventilation with that seen following high-frequency, conventional mechanical ventilation, and two different forms of high-frequency jet ventilation. Twenty-six adult cats were examined. Each was mechanically ventilated for 16 hours. Seven received standard-frequency, conventional mechanical ventilation at 20 breaths per minute. Seven received high-frequency, conventional mechanical ventilation at 150 breaths per minute. Six received high-frequency jet ventilation at 250 breaths per minute via the Instrument Development Corporation VS600 jet ventilator (IDC). Six received high-frequency jet ventilation at 400 breaths per minute via the Bunnell Life Pulse jet ventilator (BLP). A semiquantitative histopathologic scoring system graded tracheal tissue changes. All forms of high-frequency ventilation produced significant inflammation (erosion, necrosis, and polymorphonuclear leukocyte infiltration) in the trachea in the region of the endotracheal tube tip. Conventional mechanical ventilation produced less histopathology than any form of high-frequency ventilation. Of all of the ventilators examined, the BLP, the ventilator operating at the fastest rate, produced the greatest loss of surface cilia and depletion of intracellular mucus. IDC high-frequency jet ventilation and high-frequency, conventional mechanical ventilation produced nearly identical histologic injuries. In this study, significant tracheal damage occurred with all forms of high-frequency ventilation. The tracheal damage seen with high-frequency, conventional mechanical ventilation suggests that ventilator frequency, not delivery system, may be responsible for the injuries.
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机译：最近的报告指出，严重的气管损伤与各种形式的高频通气有关，这促使了这项研究。我们比较了标准频率，常规机械通气后的气管组织病理学与高频，常规机械通气和两种不同形式的高频喷射通气后的气管组织病理学。检查了26只成年猫。将每个机械通风16小时。七人接受了标准频率的常规机械通风，每分钟呼吸20次。 7人接受了高频常规机械通气，每分钟呼吸150次。六台通过Instrument Development Corporation VS600喷射通风机（IDC）以每分钟250次呼吸的速度接受了高频喷射通风。六台通过Bunnell Life Pulse喷射呼吸机（BLP）以每分钟400次呼吸的速度接受高频喷射通风。半定量组织病理评分系统对气管组织变化进行分级。各种形式的高频通气在气管内导管尖端区域的气管中产生明显的炎症（侵蚀，坏死和多形核白细胞浸润）。常规机械通气产生的组织病理学低于任何形式的高频通气。在所有检查过的呼吸机中，以最快速度运转的呼吸机BLP产生的最大表面纤毛损失和细胞内粘液消耗最大。 IDC的高频喷射通气和高频的常规机械通气产生几乎相同的组织学损伤。在这项研究中，各种形式的高频通气均会导致严重的气管损伤。常规的高频机械通气对气管的损害表明，呼吸机频率而非输送系统可能是造成伤害的原因。
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