Effects of short term high frequency negative pressure ventilation on gas exchange using the Hayek oscillator in normal subjects

Abstract

Background - The Hayek oscillator is a negative pressure cuirass that can operate at a range of frequencies to provide ventilation, and is a technique which could potentially be used on a general ward. This study examined the effect of different frequencies and different ranges of inspiratory and expiratory pressures on gas exchange, respiratory rate, and blood pressure in normal subjects. Methods - Eight normal subjects received five minute periods of ventilation using the Hayek oscillator at five different sequencies, and a combination of two spans of inspiratory and expiratory pressures and two mean chamber pressures. A 'sham' or control period was also performed at each frequency. Measurements were made of changes in gas exchange, spontaneous respiratory rate, and blood pressure before and after ventilation. Results - There was significant intersubject variation in all results, independent of their height and weight. 'Sham' settings acted as true controls in terms of gas exchange, but produced a fall in respiratory rate at 30 oscillations/min. The lower oscillatory sequencies of 30 and 60 oscillations/min produced the greatest increase in oxygenation, decrease in end tidal carbon dioxide pressure, and decrease in spontaneous respiratory rate. These effects were most significant at higher spans of pressure and were different from 'sham' settings. No adverse effects were observed on blood pressure. Conclusions - The Hayek oscillator can provide assisted ventilation for short periods in normal conscious subjects with no adverse side effects on blood pressure. Maximal changes in gas exchange and a significant reduction in the spontaneous respiratory rate are seen when a combination of lower frequencies (30 and 60 oscillations/min) and higher spans of pressure are used.