• Rolf Dembinski, Martin Max, Ralf Bensberg, Johannes Bickenbach, Ralf Kuhlen, and Rolf Rossaint.
• Klinik fuer Anaesthesiologie, Universitaetsklinikum der RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. Rolf.Dembinski@post.rwth-aachen.de
• Intensive Care Med. 2002 Jun 1; 28 (6): 768-74.

ObjectiveTo compare ventilation-perfusion (V(A)/Q) distributions during improvement of oxygenation caused by high-frequency oscillatory ventilation (HFOV) and pressure-controlled mechanical ventilation with high PEEP levels (CMV) in experimental acute lung injury (ALI).DesignProspective, controlled animal study.SettingAnimal research facility of a university hospital.InterventionsTwelve pigs with oleic acid-induced ALI were randomised to HFOV ( n=6) or to CMV ( n=6) with a PEEP of 15 mbar for 1 h. The mean airway pressure was adjusted in both groups to achieve comparable improvements in arterial oxygen partial pressure (PaO(2)) and to avoid clinically relevant impairments of cardiac output, as assured by adequate mixed venous oxygen saturation and lactate levels. V(A)/Q distributions were determined by the multiple inert gas elimination technique (MIGET).Measurements And ResultsArterial oxygen partial pressure improved during CMV with a mean airway pressure of 20 mbar ( p<0.05) whereas HFOV revealed comparable improvements with a mean airway pressure of 40 mbar ( p<0.05). Shunt decreased and blood flow to normal V(A)/Q areas increased due to CMV and HFOV ( p<0.05). The perfusion of low V(A)/Q areas remained unchanged. Statistical analysis did not reveal differences of PaO(2), shunt or blood flow to low V(A)/Q areas between the groups.ConclusionsIn this model of acute lung injury CMV and HFOV improved gas exchange due to similar changes in V(A)/Q distribution. However, mean airway pressure had to be adjusted twofold higher during HFOV then during CMV to achieve comparable improvements in gas exchange.

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