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
