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E H Bush

Publications and source records attributed to E H Bush.

4 recordsLinked to original sources

Augmentation of CO2 elimination during high frequency oscillation by removing the bias tube--an in vitro study.

In clinical applications of high frequency oscillation (HFO), sufficient CO2 elimination (VCO2) may represent a problem mainly at higher oscillation frequencies. With the intention of examining how to increase VCO2 a modified bias flow system was investigated in vitro with wash-out experiments. In bias flow systems, long tubes have been used in order to minimize the loss of oscillatory volume; however, a distinct increase of VCO2 was achieved in the present study by removing the bias tube. This improvement occurred over the whole frequency range of 2-60 Hz, although the oscillatory volume, effectively delivered to the lungs was smaller with the HFO circuit without bias tube (HFO-BT) as compared to the arrangement with bias tube (HFO + BT). A long bias tube flattens the CO2 concentration gradient from the alveoli to the atmosphere. Removing the bias tube results in a steeper CO2 concentration gradient and in a correspondingly enhanced VCO2. Furthermore, the large oscillatory volume at the exit of the bias flow system in HFO-BT supports VCO2 as an additional wash-out mechanism. Based upon longitudinal tracer gas concentration measurements between the alveoli and the atmosphere during HFO16,17, an increase of gas transport up to 20% can be expected for in vivo applications by removing the bias tube.

Carbon Dioxide

Lung surrogates.

In the development and evaluation of mechanical ventilation on the basis of high-frequency oscillation, appropriate surrogates of the lung are important, because they allow the measurement and control of various parameters which are not accessible in animal models. Yet, criteria have to be established according to which results obtained with a surrogate may be assessed with a view to extrapolation to humans. Theoretical considerations and impedance measurements are used for this purpose. It is found that for each given frequency a model can be made which exhibits realistic properties. However, no uniformly valid surrogate in the entire frequency range of 10-50 Hz is available at present.

Animals

Flow separation, an important mechanism in the formation of mean pulmonary pressure during high-frequency oscillation.

Mean pressures within the lungs and lung volume, respectively, are clinically important parameters. During ventilation by way of high-frequency oscillation (HFO), these parameters have been shown to be strongly frequency dependent. To identify mechanisms leading to mean pressure formation during HFO, findings of the theory of stationary flow were extended to oscillatory flow by a quasi-stationary approach. To confirm the theoretical findings, in-vitro experiments on HFO-models were performed. Flow separation was found to be an important mechanism in the formation of mean pressure. Flow separation causes a significant flow resistance, which may be distinctly different for in- and outflow. During oscillatory flow, a mean pressure difference thus results. This mechanism is of particular importance in bifurcations, which are present in the HFO-circuit as well as in the airways. With the direction-dependent flow separation, a general mechanism was found, which accounts for differing mean pressure values within the lungs with different HFO-circuits. This mechanism also contributes to interregionally different mean pressure values within the lungs.

High-Frequency Ventilation