Are All Oscillators Created Equal? In vitro Performance Characteristics of Eight High-Frequency Oscillatory...

The mode of waveform generation and circuit characteristics differ between high-frequency oscillators. It is unknown if this influences performance.

To describe the relationships between set and delivered pressure amplitude (x0394;P), and the interaction with frequency and endotracheal tube (ETT) diameter, in eight high-frequency oscillators.

Oscillators were evaluated using a 70-ml test lung at 1.0 and 2.0 ml/cm H2O compliance, with mean airway pressures (PAW) of 10 and 20 cm H2O, frequencies of 5, 10 and 15 Hz, and an ETT diameter of 2.5 and 3.5 mm. At each permutation of PAW, frequency and ETT, the set x0394;P was sequentially increased from 15 to 50 cm H2O, or from 20 to 100% maximum amplitude (10% increments) depending on the oscillator design. The x0394;P at the ventilator (x0394;PVENT), airway opening (x0394;PAO) and within the test lung (x0394;PTRACH), and tidal volume (V(T)) at the airway opening were determined at each set x0394;P.

In two oscillators the relationships between set and delivered x0394;P were non-linear, with a plateau in x0394;P thresholds noted at all frequencies (Dräger Babylog 8000) or ≥10 Hz (Dräger VN500). In all other devices there was a linear relationship between x0394;PVENT, x0394;PAO and x0394;PTRACH (all r2 >0.93), with differing attenuation of the pressure wave. Delivered V(T) at the different settings tested varied between devices, with some unable to deliver V(T) >3 ml at 15 Hz, and others generating V(T)>20 ml at 5 Hz and a 1:1 inspiratory-to-expiratory time ratio.

Clinicians should be aware that modern high-frequency oscillators exhibit important differences in the delivered x0394;P and V(T).