The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

ONE HOSPITAL’S EXPERIENCEWITH THE IMPLEMENTATION OF HIGH FREQUENCY OSCILLATORY VENTILATION FOR PULMONARY VERSUS EXTRAPULMONARY CAUSES OF ACUTE RESPIRATORY DISTRESS SYNDROME

Daniel P. Rausch, Reid Ikeda; Respiratory Care Services, The Queen’s Medical Center, Honolulu, HI Danny P. Rausch RRT, Reid Ikeda MD, The Queen’s Medical Center, Honolulu, HI

BACKROUND: One year after the introduction of HFOV for ARDS, a retrospective review was conducted to examine the effectiveness of HFOV in pulmonary versus extrapulmonary causes of acute respiratory distress syndrome (ARDS). A successful HFOV outcome was defined as a patient being weaned off of HFOV back to conventional mechanical ventilation. METHOD: The implementation of HFOV was evaluated on a case by case basis by the same respiratory therapist with a strict inclusion and exclusion policy of P:F ratio < 200 on positive end expiratory pressure > 10, infiltrates in 3 of 4 quadrants on chest x-ray,pulmonary artery catheter wedge pressure <18 and a mean airway pressure > 24 on conventional ventilation. RESULTS: A total of 19 patients meeting the above criteria were evaluated. Twelve patients with pulmonary causes of ARDS (predicted APACHE II mortality 55.4% ) and 7 patients with extrapulmonary causes of ARDS (predicted APACHE II mortality 49.5%) were evaluated. The results are in table one. Table 1. Results for patients with pulmonary verses extrapulmonary causes of ARDS CONCLUSION: In this small sample, both groups had an improvement in oxygenation index (OI) after 16 hours on HFOV. Although the pulmonary ARDS group had a slightly higher predicted APACHE II mortality and a higher OI before and after HFOV initiation and more total ventilator days, there was a trend toward more successful outcomes and less hospital mortality in this group. Sponsored Research - None

Table 1. Results for patients with pulmonary verses extrapulmonary causes of ARDS

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