Prospects and developments in the technologies of high frequency oscillatory ventilation_Journal of Biomedical Engineering

Authors：

 YUAN Yueyang ¹ , ZHOU Li ¹ , LIU Wei ³ , DAI Zheng ³ , CHEN Yuqing ²

1. School of Mechanical and Eectrical Engineering, Hunan City University, Yiyang, Hunan 413099, P.R.China;
2. Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai 200030, P.R.China;
3. Hunan Micomme Medical Development Co., Ltd, Changsha 410000, P.R.China;

Corresponding author：

YUAN Yueyang, Email: sunmoonanfen@163.com

Keywords：

high frequency oscillation ventilation; ventilation model; mechanisms of high frequency oscillation ventilation; ventilation mode

DOI：

10.7507/1001-5515.202003072

Video：

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Abstract Full text Figures/Tables Video References Cited by

The high frequency oscillatory ventilation (HFOV) is characterized with low tidal volume and low mean airway pressure, and can well support the breathing of the patients with respiratory diseases. Since the HFOV was proposed, it has been widely concerned by medical and scientific researchers. About the HFOV, this paper discussed its current research status and prospected its future development in technologies. The research status of ventilation model, mechanisms and ventilation mode were introduced in detail. In the next years, the technologies in developing HFOV will be focused on: to develop the branched high-order nonlinear or volume-depended resistance-inertance-compliance (RIC) ventilation model, to fully understand the mechanisms of HFOV and to achieve the noninvasive HFOV. The development in technologies of HFOV will be beneficial to the patients with respiratory diseases who failed with conventional mechanical ventilation as one of considerable ventilation methods.

Citation： YUAN Yueyang, ZHOU Li, LIU Wei, DAI Zheng, CHEN Yuqing. Prospects and developments in the technologies of high frequency oscillatory ventilation. Journal of Biomedical Engineering, 2021, 38(1): 185-190, 195. doi: 10.7507/1001-5515.202003072 Copy

1.	李欢欢, 朱兴旺, 汪万军. 无创高频振荡通气在早产儿有创机械通气撤机后呼吸支持效果的随机对照研究. 第三军医大学学报, 2019, 41(17): 1688-1692.
2.	王陈红, 施丽萍, 马晓路, 等. 无创高频振荡通气模式在极低出生体重儿呼吸支持中的应用. 中华儿科杂志, 2017, 55(3): 177-181.
3.	Golfar A, Bhogal J, Kamstra B, et al. Outcome of preterm neonates with a birth weight <1, 500 g with severe hypoxemic respiratory failure rescued by inhaled nitric oxide therapy and high-frequency oscillatory ventilation. Neonatology, 2017, 112(3): 274-280.
4.	Sklar M C, Fan E, Goligher E C. High-frequency oscillatory ventilation in adults with ARDS: past, present, and future. Chest, 2017, 152(6): 1306-1317.
5.	Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: A narrative review. Can J Respir Ther, 2019, 55: 40-46.
6.	何明嫄, 林新祝. 新生儿高频振荡通气的撤机方式探讨. 中国当代儿科杂志, 2019, 21(12): 1234-1239.
7.	Zannin E, Dellaca' R L, Dognini G, et al. Effect of frequency on pressure cost of ventilation and gas exchange in newborns receiving high-frequency oscillatory ventilation. Pediatr Res, 2017, 82(6): 994-999.
8.	Bansal N, Chauhan A S, Menon R P. A learning experience in the use of high-frequency oscillatory ventilation in infants post-cardiac surgery. Indian J Thorac Cardiovasc Surg, 2019, 35(2): 257-258.
9.	向玉萍, 曾玲, 罗天会, 等. 冠状动脉旁路移植术后低氧血症危险因素的系统评价与Meta分析. 中国胸心血管外科临床杂志, 2020, 27(8): 926-932.
10.	González-Pacheco N, Sánchez-Luna M, Chimenti-Camacho P, et al. Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury. J Perinatol, 2019, 39(5): 730-736.
11.	赖娟, 杜立中, 熊国强, 等. 1108 例新生儿呼吸衰竭的临床流行病学特征. 中国当代儿科杂志, 2016, 18(1): 10-14.
12.	Petrillo F, Gizzi C, Maffei G, et al. Neonatal respiratory support strategies for the management of extremely low gestational age infants: an Italian survey. Ital J Pediatr, 2019, 45(1): 44-48.
13.	Courtney S E, Durand D J, Asselin J M, et al. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants. N Engl J Med, 2002, 347(9): 643-652.
14.	杨旭, 陈善萍, 吕樱. 高频振荡通气在新生儿严重呼吸窘迫综合征(ARDS)的疗效及安全性分析. 临床医药文献电子杂志, 2020, 7(2): 61.
15.	娄五斌, 张卫星, 员丽, 等. 无创高频振荡通气和双水平正压通气在早产儿呼吸窘迫综合征中的临床应用效果比较研究. 中国全科医学, 2018, 21(16): 1983-1988.
16.	邵桂莲, 吕艳. 高频震荡通气辅助肺表面活性物质治疗重症胎粪吸入综合征的应用效果分析. 国际医药卫生导报, 2020, 26(8): 1090-1093.
17.	王兆康. 高频振荡通气联合猪肺磷脂治疗新生儿重症胎粪吸入综合征合并肺出血的临床效果. 广西医学, 2019, 41(10): 1246-1250.
18.	Ng J, Ferguson N D. High-frequency oscillatory ventilation: still a role?. Curr Opin Crit Care, 2017, 23(2): 175-179.
19.	Medvedev A E, Gafurova P S. Analytical design of the human bronchial tree for healthy patients and patients with obstructive pulmonary diseases. Mathemat Biol Bioinf, 2019, 14(2): 635-648.
20.	Shang Y, Dong J, Tian L, et al. Detailed computational analysis of flow dynamics in an extended respiratory airway model. Clin Biomech (Bristol, Avon), 2019, 61: 105-111.
21.	Avila N, Nazeran H, Meraz E, et al. Characterization of impulse oscillometric measures of respiratory small airway function in children. Adv Electr Electron Eng, 2019, 17(1): 54-63.
22.	Bokov P, Bafunyembaka G, Medjahdi N, et al. Cross-sectional phenotyping of small airway dysfunction in preschool asthma using the impulse oscillometry system[J/OL]. J Asthma, 2020: 1-13 [2020-03-31]. https://doi.org/10.1080/02770903.2020.1719133.
23.	Avanzolini G, Barbini P, Bernardi F, et al. Role of the mechanical properties of tracheobronchial airways in determining the respiratory resistance time course. Ann Biomed Eng, 2001, 29(7): 575-586.
24.	Polak A G, Mroczka J. Nonlinear model for mechanical ventilation of human lungs. Comput Biol Med, 2006, 36(1): 41-58.
25.	蔡永铭, 谷凌雁, 陈夫华. 基于非线性多室肺模型优化呼吸气流模式的研究. 生物医学工程学杂志, 2015, 32(1): 32-37.
26.	刘天亚, 乔惠婷, 李德玉, 等. 非线性气道分级呼吸力学模型及健康成人自主呼吸模拟. 生物医学工程学杂志, 2019, 36(1): 101-106, 115.
27.	Pillow J J. High-frequency oscillatory ventilation: mechanisms of gas exchange and lung mechanics. Crit Care Med, 2005, 33(3 suppl): S135-S141.
28.	Roth C J, Förster K M, Hilgendorff A, et al. Gas exchange mechanisms in preterm infants on HFOV - a computational approach[J/OL]. Sci Rep, 2018, 8(1): 1-8 [2020-03-31]. https://doi.org/10.1038/s41598-018-30830-x.
29.	Lee W J, Kawahashi M, Hirahara H. Experimental analysis of pendelluft flow generated by HFOV in a human airway model. Physiol Meas, 2006, 27(8): 661-674.
30.	Greenblatt E E, Butler J P, Venegas J G. Pendelluft in the bronchial tree. J Appl Physiol, 2014, 117(9): 979-988.
31.	Yuan Yueyang, Yang Chongchang, Zhe Li, et al. Oscillatory flow of HFV distributed in the left and right lungs: a model-based experiment and investigation. J Mech Med Biol, 2014, 14(6): 1-10.
32.	袁越阳, 陈宇清, 肖辉, 等. 左右肺间相互通气的高频通气机制研究. 生物医学工程学杂志, 2019, 36(3): 393-400.
33.	Leontini J, Jacob C, Tingay D. Steady streaming and conditional turbulence in high-frequency ventilation// 72nd Annual Meeting of the APS Division of Fluid Dynamics. Seattle: Bulletin of the American Physical Society, 2019, 64(13): 30.
34.	区泳儿, 陈荣昌. 2017-2018 年度无创正压通气临床研究进展. 中华结核和呼吸杂志, 2019, 42(1): 30-32.
35.	侯宇颖, 张彩云, 云荣荣, 等. 头罩式无创正压通气对成人急性呼吸衰竭疗效的 Meta 分析. 中国循证医学杂志, 2017, 17(11): 1283-1290.
36.	岳伟岗, 张志刚, 张彩云, 等. 俯卧位通气治疗急性呼吸窘迫综合征患者病死率的累积Meta分析. 中国循证医学杂志, 2017, 17(7): 792-797.
37.	张圳, 薛洋, 李洪华. 有创机械通气患儿拔管结局预测指标有效性研究进展. 中国当代儿科杂志, 2019, 21(7): 730-735.
38.	Poor H. Basics of mechanical ventilation: basic modes of ventilation. Berlin: Springer International Publishing AG, 2018: 29-38.
39.	Harris C, Thorpe S D, Rushwan S, et al. An in vitro investigation of the inflammatory response to the strain amplitudes which occur during high frequency oscillation ventilation and conventional mechanical ventilation. J Biomech, 2019, 88: 186-189.
40.	陈海山, 王明义, 谢雪娴. 早产儿应用高频振荡通气和常频机械通气并发症发生率的 Meta 分析. 中华新生儿科杂志, 2018, 33(4): P. 291-P. 297.
41.	De Luca D, Costa R, Visconti F, et al. Oscillation transmission and volume delivery during face mask-delivered HFOV in infants: Bench and in vivo study. Pediatr Pulmonol, 2016, 51(7): 705-712.
42.	Yuan Y Y, Sun J G, Wang B C, et al. A noninvasive high frequency oscillation ventilator: achieved by utilizing a blower and a valve. Rev Sci Instrum, 2016, 87(2): 38-45.
43.	Centorrino R, Dell'orto V, Gitto E, et al. Mechanics of nasal mask-delivered HFOV in neonates: A physiologic study. Pediatr Pulmonol, 2019, 54(8): 1304-1310.
44.	Attar M A, Dechert R E, Donn S M. Rescue high frequency ventilation for congenital diaphragmatic hernia. J Neonatal Perinatal Med, 2019, 12(2): 173-178.
45.	Gien J, Nuxoll C, Kinsella J P. Inhaled nitric oxide in emergency medical transport of the newborn. Neoreviews, 2020, 21(3): e157-e164.
46.	何秋明, 钟微, 吕俊健, 等. 高频振荡通气下胸腔镜补片修补巨大先天性膈疝一例并文献复习. 中华小儿外科杂志, 2019, 40(9): 806-810.
47.	De Luca D, Piastra M, Pietrini D, et al. Effect of amplitude and inspiratory time in a bench model of non-invasive HFOV through nasal prongs. Pediatr Pulmonol, 2012, 47(10): 1012-1018.
48.	Fischer H S, Bohlin K, Buehrer C A, et al. Nasal high-frequency oscillation ventilation in neonates: a survey in five European countries. Eur J Pediatr, 2015, 174(4): 465-471.

1. 李欢欢, 朱兴旺, 汪万军. 无创高频振荡通气在早产儿有创机械通气撤机后呼吸支持效果的随机对照研究. 第三军医大学学报, 2019, 41(17): 1688-1692.
2. 王陈红, 施丽萍, 马晓路, 等. 无创高频振荡通气模式在极低出生体重儿呼吸支持中的应用. 中华儿科杂志, 2017, 55(3): 177-181.
3. Golfar A, Bhogal J, Kamstra B, et al. Outcome of preterm neonates with a birth weight <1, 500 g with severe hypoxemic respiratory failure rescued by inhaled nitric oxide therapy and high-frequency oscillatory ventilation. Neonatology, 2017, 112(3): 274-280.
4. Sklar M C, Fan E, Goligher E C. High-frequency oscillatory ventilation in adults with ARDS: past, present, and future. Chest, 2017, 152(6): 1306-1317.
5. Meyers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: A narrative review. Can J Respir Ther, 2019, 55: 40-46.
6. 何明嫄, 林新祝. 新生儿高频振荡通气的撤机方式探讨. 中国当代儿科杂志, 2019, 21(12): 1234-1239.
7. Zannin E, Dellaca' R L, Dognini G, et al. Effect of frequency on pressure cost of ventilation and gas exchange in newborns receiving high-frequency oscillatory ventilation. Pediatr Res, 2017, 82(6): 994-999.
8. Bansal N, Chauhan A S, Menon R P. A learning experience in the use of high-frequency oscillatory ventilation in infants post-cardiac surgery. Indian J Thorac Cardiovasc Surg, 2019, 35(2): 257-258.
9. 向玉萍, 曾玲, 罗天会, 等. 冠状动脉旁路移植术后低氧血症危险因素的系统评价与Meta分析. 中国胸心血管外科临床杂志, 2020, 27(8): 926-932.
10. González-Pacheco N, Sánchez-Luna M, Chimenti-Camacho P, et al. Use of very low tidal volumes during high-frequency ventilation reduces ventilator lung injury. J Perinatol, 2019, 39(5): 730-736.
11. 赖娟, 杜立中, 熊国强, 等. 1108 例新生儿呼吸衰竭的临床流行病学特征. 中国当代儿科杂志, 2016, 18(1): 10-14.
12. Petrillo F, Gizzi C, Maffei G, et al. Neonatal respiratory support strategies for the management of extremely low gestational age infants: an Italian survey. Ital J Pediatr, 2019, 45(1): 44-48.
13. Courtney S E, Durand D J, Asselin J M, et al. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants. N Engl J Med, 2002, 347(9): 643-652.
14. 杨旭, 陈善萍, 吕樱. 高频振荡通气在新生儿严重呼吸窘迫综合征(ARDS)的疗效及安全性分析. 临床医药文献电子杂志, 2020, 7(2): 61.
15. 娄五斌, 张卫星, 员丽, 等. 无创高频振荡通气和双水平正压通气在早产儿呼吸窘迫综合征中的临床应用效果比较研究. 中国全科医学, 2018, 21(16): 1983-1988.
16. 邵桂莲, 吕艳. 高频震荡通气辅助肺表面活性物质治疗重症胎粪吸入综合征的应用效果分析. 国际医药卫生导报, 2020, 26(8): 1090-1093.
17. 王兆康. 高频振荡通气联合猪肺磷脂治疗新生儿重症胎粪吸入综合征合并肺出血的临床效果. 广西医学, 2019, 41(10): 1246-1250.
18. Ng J, Ferguson N D. High-frequency oscillatory ventilation: still a role?. Curr Opin Crit Care, 2017, 23(2): 175-179.
19. Medvedev A E, Gafurova P S. Analytical design of the human bronchial tree for healthy patients and patients with obstructive pulmonary diseases. Mathemat Biol Bioinf, 2019, 14(2): 635-648.
20. Shang Y, Dong J, Tian L, et al. Detailed computational analysis of flow dynamics in an extended respiratory airway model. Clin Biomech (Bristol, Avon), 2019, 61: 105-111.
21. Avila N, Nazeran H, Meraz E, et al. Characterization of impulse oscillometric measures of respiratory small airway function in children. Adv Electr Electron Eng, 2019, 17(1): 54-63.
22. Bokov P, Bafunyembaka G, Medjahdi N, et al. Cross-sectional phenotyping of small airway dysfunction in preschool asthma using the impulse oscillometry system[J/OL]. J Asthma, 2020: 1-13 [2020-03-31]. https://doi.org/10.1080/02770903.2020.1719133.
23. Avanzolini G, Barbini P, Bernardi F, et al. Role of the mechanical properties of tracheobronchial airways in determining the respiratory resistance time course. Ann Biomed Eng, 2001, 29(7): 575-586.
24. Polak A G, Mroczka J. Nonlinear model for mechanical ventilation of human lungs. Comput Biol Med, 2006, 36(1): 41-58.
25. 蔡永铭, 谷凌雁, 陈夫华. 基于非线性多室肺模型优化呼吸气流模式的研究. 生物医学工程学杂志, 2015, 32(1): 32-37.
26. 刘天亚, 乔惠婷, 李德玉, 等. 非线性气道分级呼吸力学模型及健康成人自主呼吸模拟. 生物医学工程学杂志, 2019, 36(1): 101-106, 115.
27. Pillow J J. High-frequency oscillatory ventilation: mechanisms of gas exchange and lung mechanics. Crit Care Med, 2005, 33(3 suppl): S135-S141.
28. Roth C J, Förster K M, Hilgendorff A, et al. Gas exchange mechanisms in preterm infants on HFOV - a computational approach[J/OL]. Sci Rep, 2018, 8(1): 1-8 [2020-03-31]. https://doi.org/10.1038/s41598-018-30830-x.
29. Lee W J, Kawahashi M, Hirahara H. Experimental analysis of pendelluft flow generated by HFOV in a human airway model. Physiol Meas, 2006, 27(8): 661-674.
30. Greenblatt E E, Butler J P, Venegas J G. Pendelluft in the bronchial tree. J Appl Physiol, 2014, 117(9): 979-988.
31. Yuan Yueyang, Yang Chongchang, Zhe Li, et al. Oscillatory flow of HFV distributed in the left and right lungs: a model-based experiment and investigation. J Mech Med Biol, 2014, 14(6): 1-10.
32. 袁越阳, 陈宇清, 肖辉, 等. 左右肺间相互通气的高频通气机制研究. 生物医学工程学杂志, 2019, 36(3): 393-400.
33. Leontini J, Jacob C, Tingay D. Steady streaming and conditional turbulence in high-frequency ventilation// 72nd Annual Meeting of the APS Division of Fluid Dynamics. Seattle: Bulletin of the American Physical Society, 2019, 64(13): 30.
34. 区泳儿, 陈荣昌. 2017-2018 年度无创正压通气临床研究进展. 中华结核和呼吸杂志, 2019, 42(1): 30-32.
35. 侯宇颖, 张彩云, 云荣荣, 等. 头罩式无创正压通气对成人急性呼吸衰竭疗效的 Meta 分析. 中国循证医学杂志, 2017, 17(11): 1283-1290.
36. 岳伟岗, 张志刚, 张彩云, 等. 俯卧位通气治疗急性呼吸窘迫综合征患者病死率的累积Meta分析. 中国循证医学杂志, 2017, 17(7): 792-797.
37. 张圳, 薛洋, 李洪华. 有创机械通气患儿拔管结局预测指标有效性研究进展. 中国当代儿科杂志, 2019, 21(7): 730-735.
38. Poor H. Basics of mechanical ventilation: basic modes of ventilation. Berlin: Springer International Publishing AG, 2018: 29-38.
39. Harris C, Thorpe S D, Rushwan S, et al. An in vitro investigation of the inflammatory response to the strain amplitudes which occur during high frequency oscillation ventilation and conventional mechanical ventilation. J Biomech, 2019, 88: 186-189.
40. 陈海山, 王明义, 谢雪娴. 早产儿应用高频振荡通气和常频机械通气并发症发生率的 Meta 分析. 中华新生儿科杂志, 2018, 33(4): P. 291-P. 297.
41. De Luca D, Costa R, Visconti F, et al. Oscillation transmission and volume delivery during face mask-delivered HFOV in infants: Bench and in vivo study. Pediatr Pulmonol, 2016, 51(7): 705-712.
42. Yuan Y Y, Sun J G, Wang B C, et al. A noninvasive high frequency oscillation ventilator: achieved by utilizing a blower and a valve. Rev Sci Instrum, 2016, 87(2): 38-45.
43. Centorrino R, Dell'orto V, Gitto E, et al. Mechanics of nasal mask-delivered HFOV in neonates: A physiologic study. Pediatr Pulmonol, 2019, 54(8): 1304-1310.
44. Attar M A, Dechert R E, Donn S M. Rescue high frequency ventilation for congenital diaphragmatic hernia. J Neonatal Perinatal Med, 2019, 12(2): 173-178.
45. Gien J, Nuxoll C, Kinsella J P. Inhaled nitric oxide in emergency medical transport of the newborn. Neoreviews, 2020, 21(3): e157-e164.
46. 何秋明, 钟微, 吕俊健, 等. 高频振荡通气下胸腔镜补片修补巨大先天性膈疝一例并文献复习. 中华小儿外科杂志, 2019, 40(9): 806-810.
47. De Luca D, Piastra M, Pietrini D, et al. Effect of amplitude and inspiratory time in a bench model of non-invasive HFOV through nasal prongs. Pediatr Pulmonol, 2012, 47(10): 1012-1018.
48. Fischer H S, Bohlin K, Buehrer C A, et al. Nasal high-frequency oscillation ventilation in neonates: a survey in five European countries. Eur J Pediatr, 2015, 174(4): 465-471.

Journal of Biomedical Engineering

Prospects and developments in the technologies of high frequency oscillatory ventilation

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