hi all 

Can anybody please explain to me the role of I:E ratio if high oscillatory ventilation.

and also  what is PEEP in HFOV?

 

thanks

 

In HFOV , the  parameters  setting  does not include  I:E，or  PEEP

 hi i know PEEP not there insetting just asking .but IE ration radio buttonnthere in SLE 6000.

Dear sir

Normally one starts off with I:E ratio of 1:2 or in some ventilators represented as a percentage like 33%.what it means is if you have selected a frequency of 10Hz( resp rate of 600) then total Ti for a single breath would be 0.03 seconds. Remember that this IE is for each oscillation and not for recruiting breaths (that has a separate entry parameter) 

This conventional 1:2 comes from the expiratory time constant which is twice as long as inspiratory. 

For a given MAP if i am able to manage oxygenation i would not touch on the IE ratio.if you feel that you are not able to maintain oxygenation for a give MAP, in order to recruit more alveolar units one may consider increasing IE to 1:1. But  this might result in issues with ventilation also. It is always better to recruit with titrating MAP rather than I:E

Regards 

This is an extract from Prof Jane Pillow's book on HFOV and its applications:

You can access the entire publication free of charge from this website - https://www.draeger.com/Library/Content/hfov-bk-9102693-en.pdf - most definitely worth reading!

I hope that is helpful!

Kind regards

 

 

You can't think about I/E and PEEP, it's a completely different ventilation principle 

WNHS.NEO.VentilationHighFrequencyOscillatoryVentilationHFOV.pdf

Thanks everybody for reply.i read all links and then reply

Hi everybody.

I want to ask for dr akash sharma sir.

As in HFO there is active expiration how ventilation manage to keep 1:2  (2 here is time of expiration). Hope you understand my question.

Like to reactivate this question as it is really from our daily practice .. so like to read more about it . What I can share from our practice 

To change ration 1:2 to be 1:1 is when I have a baby washing CO2, badly with highest frequency possible ( 15), and lowest amplitude with which wiggles can still be evident( we use no less than 15) , so here 1:1 is my next step, in order to limit the CO2 washing , as well help oxygenation, but consider that the case is not already with hyperinflated lungs 🫁, as 1:1 can worsen this part . Again physiology and ogysiodynamics of this depends on the absolute tidal volume delivered.. 

simply, changing IE ratio from 1:2 to 1:1 will increase the tidal volume and cause more CO2 wash

PEEP is the MAP in HFV