Saturday, November 3, 2012

The Versatility of Mid-Frequency Ventilation

MFV first proposed in the medical literature in 2008 as a “conceptual” [1] ventilator modality which maximizes alveolar ventilation and minimizes the delivered tidal volume. MFV provides an alternative to traditional Volume-Control (VC) ventilation for patients with ARDS. This is extremely beneficial because lung protective strategies using VC ventilation are limited by predestined hypercapnia and hypercapnic acidosis.

After this proposition I myself have utilized MFV in a patient with ARDS and as a lung protective strategy to prevent ventilator induced lung injury. These patient cases demonstrated to me the versatility of the mode.

At this year’s AARC International conference respiratory therapists from the Cleveland Clinic will present their abstract “Independent Lung Ventilation Using Mid-Frequency Ventilation in Single Lung Pulmonary Hemorrhage of Unknown Origin”. The case study reinforces the flexibility of MFV providing a lung protective ventilatory strategy both intra-operatively and in the ICU for independent lung ventilation (ILV). 

So why is MFV so resourceful?

  1. Easy to understand- based on Pressure Control-Continuous Mandatory Ventilation.
  2. Can apply with almost any intensive care unit ventilator or a sophisticated transport ventilator (as long as it has PC-CMV).
  3. Do not need unlimited resources- can use technology that is currently in your facility.

Novel/ Potential uses for MFV.

  1. Intra-operative- any cardio-thoracic procedure that requires ILV, or robotic assisted thoracic procedures.
  2. Electrophysiology procedures- specifically ablation procedures which require very little chest wall movement.

[1]. MFV is a conceptual mode- MFV is not an available mode of ventilation but the application of PC-CMV with frequencies greater than 35 breaths per minute. Optimal frequencies are calculated using mathematical models of PC-CMV.