The Influence of High-Frequency Jet Ventilation With Varying Cardiac-Cycle Specific Synchronization on Cardiac Output in ARDS
Previous studies have shown “beat-to-beat” variation in systemic BP with high-frequency jet ventilation (HFJV). However, it is not clear if such changes are paralleled by changes in cardiac output. To characterize the effect of HFJV near or equal to the heart rate (HR) on beat-to-beat cardiac output...
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| Veröffentlicht in: | Chest 1997-12, Vol.112 (6), p.1600-1606 |
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| creator | Angus, Derek C. Lidsky, Nathan M. Dotterweich, Lisa M. Pinsky, Michael R. |
| description | Previous studies have shown “beat-to-beat” variation in systemic BP with high-frequency jet ventilation (HFJV). However, it is not clear if such changes are paralleled by changes in cardiac output.
To characterize the effect of HFJV near or equal to the heart rate (HR) on beat-to-beat cardiac output in an adult human subject with ARDS.
Case study.
ICU, university teaching hospital.
One patient with end-stage liver disease complicated by sepsis, severe pancreatitis, ARDS, and multisystem organ failure.
The patient was intubated, sedated, paralyzed, and ventilated with controlled mechanical ventilation (CMV). Ventilatory mode was then switched to HFJV at fixed frequencies (f) near but not equal to the HR (f=100, 110, and 120 beats/min; HR=108/min). HFJV was then synchronized to the ECG such that f and HR were equal. Continuous cardiac output (COc) was monitored during change of ventilator mode from CMV to fixed-rate HFJV to synchronized HFJV, then followed through progressive delays in jet triggering within the cardiac cycle during the synchronous HFJV mode. COc was monitored by arterial pulse-contour analysis, allowing assessment of beat-to-beat changes in cardiac output.
A cyclic variation in COc equal to the beat frequency difference between f and HR was observed (harmonic interaction) during fixed-rate HFJV. This COc oscillation was abolished during synchronous HFJV. COc was significantly greater during systolic synchronous HFJV as compared to diastolic synchronous HFJV or fixed-rate HFJV (10.1 to 9.0 [p |
| doi_str_mv | 10.1378/chest.112.6.1600 |
| format | Article |
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To characterize the effect of HFJV near or equal to the heart rate (HR) on beat-to-beat cardiac output in an adult human subject with ARDS.
Case study.
ICU, university teaching hospital.
One patient with end-stage liver disease complicated by sepsis, severe pancreatitis, ARDS, and multisystem organ failure.
The patient was intubated, sedated, paralyzed, and ventilated with controlled mechanical ventilation (CMV). Ventilatory mode was then switched to HFJV at fixed frequencies (f) near but not equal to the HR (f=100, 110, and 120 beats/min; HR=108/min). HFJV was then synchronized to the ECG such that f and HR were equal. Continuous cardiac output (COc) was monitored during change of ventilator mode from CMV to fixed-rate HFJV to synchronized HFJV, then followed through progressive delays in jet triggering within the cardiac cycle during the synchronous HFJV mode. COc was monitored by arterial pulse-contour analysis, allowing assessment of beat-to-beat changes in cardiac output.
A cyclic variation in COc equal to the beat frequency difference between f and HR was observed (harmonic interaction) during fixed-rate HFJV. This COc oscillation was abolished during synchronous HFJV. COc was significantly greater during systolic synchronous HFJV as compared to diastolic synchronous HFJV or fixed-rate HFJV (10.1 to 9.0 [p<0.05] and to 8.6 [p<0.05] L/min, systolic synchronous to diastolic synchronous and to fixed-rate HFJV, respectively).
This study demonstrates instantaneous variations in cardiac output in a human subject with fixed rates of HFJV near to the HR in humans. These variations are abolished by synchronous HFJV but cardiac output was dependent on the timing of the HFJV inspiration in relation to the cardiac cycle. COc is a potentially valuable method to monitor sudden changes in cardiac output and facilitate attempts to maximize cardiac output during synchronized HFJV.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.112.6.1600</identifier><identifier>PMID: 9404760</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: Elsevier Inc</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; ARDS ; Biological and medical sciences ; Cardiac Output ; cardiac synchronization ; continuous cardiac output monitor ; Emergency and intensive respiratory care ; Fatal Outcome ; Heart Rate ; high-frequency jet ventilation ; High-Frequency Jet Ventilation - instrumentation ; High-Frequency Jet Ventilation - methods ; Humans ; Intensive care medicine ; Liver Failure - physiopathology ; Liver Failure - therapy ; Male ; Medical sciences ; Monitoring, Physiologic - instrumentation ; Monitoring, Physiologic - methods ; Multiple Organ Failure - physiopathology ; Multiple Organ Failure - therapy ; Pancreatitis - physiopathology ; Pancreatitis - therapy ; Respiratory Distress Syndrome, Adult - physiopathology ; Respiratory Distress Syndrome, Adult - therapy ; sepsis</subject><ispartof>Chest, 1997-12, Vol.112 (6), p.1600-1606</ispartof><rights>1997 The American College of Chest Physicians</rights><rights>1998 INIST-CNRS</rights><rights>Copyright American College of Chest Physicians Dec 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-42c2779a7e31d14cd9e0626b7eb3c3c397a0f53bf83f1a391efa5e975fb4decf3</citedby><cites>FETCH-LOGICAL-c442t-42c2779a7e31d14cd9e0626b7eb3c3c397a0f53bf83f1a391efa5e975fb4decf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2088769$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9404760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Angus, Derek C.</creatorcontrib><creatorcontrib>Lidsky, Nathan M.</creatorcontrib><creatorcontrib>Dotterweich, Lisa M.</creatorcontrib><creatorcontrib>Pinsky, Michael R.</creatorcontrib><title>The Influence of High-Frequency Jet Ventilation With Varying Cardiac-Cycle Specific Synchronization on Cardiac Output in ARDS</title><title>Chest</title><addtitle>Chest</addtitle><description>Previous studies have shown “beat-to-beat” variation in systemic BP with high-frequency jet ventilation (HFJV). However, it is not clear if such changes are paralleled by changes in cardiac output.
To characterize the effect of HFJV near or equal to the heart rate (HR) on beat-to-beat cardiac output in an adult human subject with ARDS.
Case study.
ICU, university teaching hospital.
One patient with end-stage liver disease complicated by sepsis, severe pancreatitis, ARDS, and multisystem organ failure.
The patient was intubated, sedated, paralyzed, and ventilated with controlled mechanical ventilation (CMV). Ventilatory mode was then switched to HFJV at fixed frequencies (f) near but not equal to the HR (f=100, 110, and 120 beats/min; HR=108/min). HFJV was then synchronized to the ECG such that f and HR were equal. Continuous cardiac output (COc) was monitored during change of ventilator mode from CMV to fixed-rate HFJV to synchronized HFJV, then followed through progressive delays in jet triggering within the cardiac cycle during the synchronous HFJV mode. COc was monitored by arterial pulse-contour analysis, allowing assessment of beat-to-beat changes in cardiac output.
A cyclic variation in COc equal to the beat frequency difference between f and HR was observed (harmonic interaction) during fixed-rate HFJV. This COc oscillation was abolished during synchronous HFJV. COc was significantly greater during systolic synchronous HFJV as compared to diastolic synchronous HFJV or fixed-rate HFJV (10.1 to 9.0 [p<0.05] and to 8.6 [p<0.05] L/min, systolic synchronous to diastolic synchronous and to fixed-rate HFJV, respectively).
This study demonstrates instantaneous variations in cardiac output in a human subject with fixed rates of HFJV near to the HR in humans. These variations are abolished by synchronous HFJV but cardiac output was dependent on the timing of the HFJV inspiration in relation to the cardiac cycle. COc is a potentially valuable method to monitor sudden changes in cardiac output and facilitate attempts to maximize cardiac output during synchronized HFJV.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>ARDS</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output</subject><subject>cardiac synchronization</subject><subject>continuous cardiac output monitor</subject><subject>Emergency and intensive respiratory care</subject><subject>Fatal Outcome</subject><subject>Heart Rate</subject><subject>high-frequency jet ventilation</subject><subject>High-Frequency Jet Ventilation - instrumentation</subject><subject>High-Frequency Jet Ventilation - methods</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Liver Failure - physiopathology</subject><subject>Liver Failure - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Monitoring, Physiologic - instrumentation</subject><subject>Monitoring, Physiologic - methods</subject><subject>Multiple Organ Failure - physiopathology</subject><subject>Multiple Organ Failure - therapy</subject><subject>Pancreatitis - physiopathology</subject><subject>Pancreatitis - therapy</subject><subject>Respiratory Distress Syndrome, Adult - physiopathology</subject><subject>Respiratory Distress Syndrome, Adult - therapy</subject><subject>sepsis</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kd9rFDEQx4Mo9ay--yIEEd_2zK_dXHwrZ2srhYJX62PIZifdlL3smexaTvB_N-cuFQVJICTz_c5M5oPQS0qWlMvVO9tCGpaUsmW1pBUhj9CCKk4LXgr-GC0IoazglWJP0bOU7ki-U1UdoSMliJAVWaCf1y3gi-C6EYIF3Dt87m_b4izCt8PLHn-CAd9AGHxnBt8H_NUPLb4xce_DLV6b2Hhji_XedoA3O7DeeYs3-2Db2Af_Y_LkPSvx1TjsxgH7gE8-f9g8R0-c6RK8mM9j9OXs9Hp9XlxefbxYn1wWVgg2FIJZJqUyEjhtqLCNAlKxqpZQc5uXkoa4ktduxR01XFFwpgQlS1eLBqzjx-jtlHcX-_yvNOitTxa6zgTox6SlEpKpkmXh63-Ed_0YQ-5NM0IEUSshsohMIhv7lCI4vYt-m0eiKdEHLPo3Fp2x6EofsGTLqznvWG-heTDMHHL8zRw3yZrORROsTw8yRlYrWak_ldsM6d5H0Glrui4n5VPNudu_Kr-fLJDn-91D1Mn6A-sm2-2gm97_v-1fCSS7zg</recordid><startdate>19971201</startdate><enddate>19971201</enddate><creator>Angus, Derek C.</creator><creator>Lidsky, Nathan M.</creator><creator>Dotterweich, Lisa M.</creator><creator>Pinsky, Michael R.</creator><general>Elsevier Inc</general><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>19971201</creationdate><title>The Influence of High-Frequency Jet Ventilation With Varying Cardiac-Cycle Specific Synchronization on Cardiac Output in ARDS</title><author>Angus, Derek C. ; Lidsky, Nathan M. ; Dotterweich, Lisa M. ; Pinsky, Michael R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-42c2779a7e31d14cd9e0626b7eb3c3c397a0f53bf83f1a391efa5e975fb4decf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>ARDS</topic><topic>Biological and medical sciences</topic><topic>Cardiac Output</topic><topic>cardiac synchronization</topic><topic>continuous cardiac output monitor</topic><topic>Emergency and intensive respiratory care</topic><topic>Fatal Outcome</topic><topic>Heart Rate</topic><topic>high-frequency jet ventilation</topic><topic>High-Frequency Jet Ventilation - instrumentation</topic><topic>High-Frequency Jet Ventilation - methods</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Liver Failure - physiopathology</topic><topic>Liver Failure - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Monitoring, Physiologic - instrumentation</topic><topic>Monitoring, Physiologic - methods</topic><topic>Multiple Organ Failure - physiopathology</topic><topic>Multiple Organ Failure - therapy</topic><topic>Pancreatitis - physiopathology</topic><topic>Pancreatitis - therapy</topic><topic>Respiratory Distress Syndrome, Adult - physiopathology</topic><topic>Respiratory Distress Syndrome, Adult - therapy</topic><topic>sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Angus, Derek C.</creatorcontrib><creatorcontrib>Lidsky, Nathan M.</creatorcontrib><creatorcontrib>Dotterweich, Lisa M.</creatorcontrib><creatorcontrib>Pinsky, Michael R.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Angus, Derek C.</au><au>Lidsky, Nathan M.</au><au>Dotterweich, Lisa M.</au><au>Pinsky, Michael R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Influence of High-Frequency Jet Ventilation With Varying Cardiac-Cycle Specific Synchronization on Cardiac Output in ARDS</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>1997-12-01</date><risdate>1997</risdate><volume>112</volume><issue>6</issue><spage>1600</spage><epage>1606</epage><pages>1600-1606</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Previous studies have shown “beat-to-beat” variation in systemic BP with high-frequency jet ventilation (HFJV). However, it is not clear if such changes are paralleled by changes in cardiac output.
To characterize the effect of HFJV near or equal to the heart rate (HR) on beat-to-beat cardiac output in an adult human subject with ARDS.
Case study.
ICU, university teaching hospital.
One patient with end-stage liver disease complicated by sepsis, severe pancreatitis, ARDS, and multisystem organ failure.
The patient was intubated, sedated, paralyzed, and ventilated with controlled mechanical ventilation (CMV). Ventilatory mode was then switched to HFJV at fixed frequencies (f) near but not equal to the HR (f=100, 110, and 120 beats/min; HR=108/min). HFJV was then synchronized to the ECG such that f and HR were equal. Continuous cardiac output (COc) was monitored during change of ventilator mode from CMV to fixed-rate HFJV to synchronized HFJV, then followed through progressive delays in jet triggering within the cardiac cycle during the synchronous HFJV mode. COc was monitored by arterial pulse-contour analysis, allowing assessment of beat-to-beat changes in cardiac output.
A cyclic variation in COc equal to the beat frequency difference between f and HR was observed (harmonic interaction) during fixed-rate HFJV. This COc oscillation was abolished during synchronous HFJV. COc was significantly greater during systolic synchronous HFJV as compared to diastolic synchronous HFJV or fixed-rate HFJV (10.1 to 9.0 [p<0.05] and to 8.6 [p<0.05] L/min, systolic synchronous to diastolic synchronous and to fixed-rate HFJV, respectively).
This study demonstrates instantaneous variations in cardiac output in a human subject with fixed rates of HFJV near to the HR in humans. These variations are abolished by synchronous HFJV but cardiac output was dependent on the timing of the HFJV inspiration in relation to the cardiac cycle. COc is a potentially valuable method to monitor sudden changes in cardiac output and facilitate attempts to maximize cardiac output during synchronized HFJV.</abstract><cop>Northbrook, IL</cop><pub>Elsevier Inc</pub><pmid>9404760</pmid><doi>10.1378/chest.112.6.1600</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Chest, 1997-12, Vol.112 (6), p.1600-1606 |
| issn | 0012-3692 1931-3543 |
| language | eng |
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| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ARDS Biological and medical sciences Cardiac Output cardiac synchronization continuous cardiac output monitor Emergency and intensive respiratory care Fatal Outcome Heart Rate high-frequency jet ventilation High-Frequency Jet Ventilation - instrumentation High-Frequency Jet Ventilation - methods Humans Intensive care medicine Liver Failure - physiopathology Liver Failure - therapy Male Medical sciences Monitoring, Physiologic - instrumentation Monitoring, Physiologic - methods Multiple Organ Failure - physiopathology Multiple Organ Failure - therapy Pancreatitis - physiopathology Pancreatitis - therapy Respiratory Distress Syndrome, Adult - physiopathology Respiratory Distress Syndrome, Adult - therapy sepsis |
| title | The Influence of High-Frequency Jet Ventilation With Varying Cardiac-Cycle Specific Synchronization on Cardiac Output in ARDS |
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