Patients at the Intensive Care Unit (ICU) Clinical Trial
Official title:
The Effect of High Frequency Percussive Ventilation on Cerebral Tissue Oxygenation
Hypoxemia is commonly reported in patients admitted to the Intensive Care Unit (ICU) and may
result from acute lung injury/acute respiratory distress syndrome (ALI/ARDS), sepsis, trauma
and postoperative complications. In an attempt to preserve or increase the oxygenation,
conventional mechanical ventilation is initiated in these patients. Unfortunately, patients
frequently become refractory to standard ventilatory techniques and as such, gas exchange
remains unaltered or becomes worse. High Frequency Percussive Ventilation (HFPV), on the
other hand, is an advanced mode of ventilation which can be a salvage option in these patient
cohorts as it has already been proven to improve gas exchange with success. The volumetric
diffusive respirator (VDR-4; Percussionary, Corp., Sandpoint, ID) is the only commercially
available system to deliver HFPV. This ventilator mechanically ventilates the lung by
administering small successive subtidal volumes or percussions at unconventional high
frequencies to reach an optimal diffusive oxygenation.
Since it has been known that hypoxemia due to a reduced oxygenation results in secondary
brain injury, it is conceivable that the cerebral tissue oxygenation might be impaired as
well. It has been strongly suggested that a cerebral tissue oxygenation in the optimal range
has an ameliorative influence on hypoxic events and in turn leads to a better clinical
outcome. Thus far, no studies have been conducted to investigate if an improved oxygenation
by means of a switch to HFPV automatically leads to an increment in the cerebral tissue
oxygenation. With the use of Near-Infrared Spectroscopy (NIRS) technology, investigators will
investigate whether this alternation of ventilation strategy is associated with a
(beneficial) change of the cerebral tissue oxygenation.
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