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High-frequency percussive ventilation and low tidal volume ventilation in burns: a randomized controlled trial
Kevin K Chung1, Steven E Wolf, Evan M Renz
1U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA. Kevin.chung@amedd.army.mil
Critical Care Medicine
|July 20, 2010
Summary
High-frequency percussive ventilation and low-tidal volume ventilation showed similar outcomes in burn patients with respiratory failure. However, low-tidal volume ventilation required rescue ventilation more often.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
- Burn Management
Background:
- High-frequency percussive ventilation (HFPV) is often used in burn ICUs for patients with acute lung injury, ARDS, and inhalation injury.
- Prospective studies comparing HFPV with current low-tidal volume ventilation (LTVV) strategies are lacking.
Purpose of the Study:
- To prospectively compare HFPV and LTVV in burn patients with respiratory failure within a burn intensive care unit setting.
Main Methods:
- A single-center, prospective, randomized controlled trial was conducted in a 16-bed burn intensive care unit.
- Adult patients requiring prolonged mechanical ventilation were randomized to either HFPV (n=31) or LTVV (n=31).
- The primary outcome was ventilator-free days within 28 days; secondary outcomes included mortality and need for rescue ventilation.
Main Results:
- No significant difference was found in mean ventilator-free days between HFPV and LTVV groups (12±9 vs. 11±9).
- Mortality and other secondary outcomes were similar between groups.
- Significantly fewer patients in the HFPV group required rescue ventilation (6%) compared to the LTVV group (29%) (p=0.02).
Conclusions:
- HFPV and LTVV strategies yield comparable clinical outcomes in burn patients with respiratory failure.
- The LTVV strategy was less effective in achieving initial oxygenation and ventilation goals, necessitating rescue ventilation in a higher proportion of patients.
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