Nitrogen washout during tidal breathing with superimposed high-frequency chest wall oscillation

In order to assess the efficacy of high-frequency chest wall oscillation (HFCWO) superimposed on tidal ventilation, multiple-breath nitrogen washout curves were obtained in 7 normal seated subjects. To maintain a regular breathing pattern throughout the study, the subjects breathed synchronously with a Harvard ventilator set at a constant tidal volume and frequency for each subject during a trial period. Washout curves were obtained during 3 different maneuvers performed in random order. Series A was the control condition with no superimposed HFCWO. In Series B and C, HFCWO at 5 Hz was superimposed on the regulated tidal breathing; the magnitude of the oscillatory tidal volume measured at the airway opening was 20 ml for Series B and 40 ml for Series C. The nitrogen washout was clearly faster in Series C than in Series A for each subject. In Series B, there was an interindividual variability, with a washout rate either equal to that in Maneuver A or in Maneuver C, or intermediate between the two. When these washout curves were analyzed in terms of a simple monocompartment model, the time constant of the washout was found to decrease by 16 +/- 11% in Series B, and 25 +/- 7% in Series C compared with that in Series A. In this group of normal subjects, the correction of any inhomogeneity in the distribution of the ventilation is unlikely to explain these results because of the close fit of all washout curves to a monoexponential model. It is postulated that during inspiration HFCWO enhances gas mixing in the lung periphery and that during expiration it improves gas mixing in the airways.(ABSTRACT TRUNCATED AT 250 WORDS)