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• W2037260063 abstract "High frequency ventilation of the lungs has become the most popular subject for research papers and review articles in the anaesthetic literature, with well over 1000 titles published so far. Why should this be so? The question has many answers. To the clinician, high frequency ventilation offers the prospect of improved patient care and perhaps reduced morbidity and mortality in the operating theatre and in critical care. To the respiratory physiologist is poses what at first sight appears to be a fundamental challenge to the accepted laws of respiratory mechanics, with adequate gaseous exchange resulting from the use of a tidal volume equal to, or even less than, the apparent deadspace volume. To the physicist it is a phenomenon which demands investigation and explanation within the framework of the laws of thermodynamics, acoustics and fluidics. Even research biologists believe investigation of this subject may hold the key to understanding the gaseous exchange mechanisms in the lungs of lower animals and birds [47]. The most fundamental difference between high frequency ventilation (HFV) and conventional intermittent positive pressure ventilation (IPPV) is with HFV the tidal volume (FT) required is approximately 1-3 ml kg/body weight, compared with 6-10 ml with IPPV. The increase in ventilation rate to frequencies of 60 b.p.m. or more in HFV is obviously mandatory if even comparable minute volume ventilation is to result. What is fascinating is that, if FT is reduced to the apparent physiological deadspace volume, in theory even an infinite increase in frequency could not restore adequate alveolar ventilation. The obvious solution to this paradox must be the physiological deadspace volume is smaller than the generally accepted value of 2 ml kg1, at least in some situations. The concept pulmonary gas exchange could be maintained with such small tidal volumes is not new. As long ago as 1915, Henderson, Chillingworth and Whitney [24] speculated there may easily be gaseous exchange sufficient to support life even when the tidal volume is considerably less than the dead space. A series of simple but elegant experiments reinforced this view. They showed tobacco smoke blown into a tube formed a long thin central plume, and that the quicker the puff, the thinner and sharper the spike of smoke. When the puff of smoke stopped, the spike breaks instantly everywhere and the tube is seen to be filled from side to side" @default.
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• W2037260063 date "1990-07-01" @default.
• W2037260063 modified "2023-10-18" @default.
• W2037260063 title "HIGH FREQUENCY VENTILATION: PAST, PRESENT AND FUTURE?" @default.
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• W2037260063 doi "https://doi.org/10.1093/bja/65.1.130" @default.
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