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VDR=DevelopedbyDrForestMBird–UsedsuccessfullysinceapproxcINTRODUCTION:Highfrequencypercussiveventilation(HFPV)isamodalitythat deliverspneumaticallypowered,pressurelimited,timecycledandflow-interruptedbreathswithbiphasicoscillation.Itdeliversbiphasicoscillatorybreaths,withthe tidalvolumebeingtheproductofthePIPsettingandsubtidalvolumesproducedbytheoscillationsThismanualwasoriginallyreleasedandsuppliedinEnglishIf yourpatientisbeingVentilatedwiththeVDR,anRTwillbepresentasmuchaspossibleTheServoIVentilatorCircuitaTheBirdVDRconceptswere theoreticallyadvancedasameansofprovidingforaventilatorydevicethatwouldallowcontroloverintrabronchialdiffusionaswellasNoninvasive,continuous digitalmonitoringsystemsthatenablelessinvasivecareHigh-frequencyoscillationisauniqueandthemostwell-knownandusedformofhigh-frequency ventilationAmechanicalventilatoreitherfullyorpartiallysupportsapatient’sworkofbreathingMPercussionaire®CorporationPPercussionaire®Corporation GlengaryBayRoad,SagleIDUSABelgiumOfficeP.O.Box,Sandpoint,IDUSABreemstraatTelephonePerk,BelgiumForalistofavailabletranslations,contact customerservice@Allventilatorsshouldbeoperatedandservicedonlyb.InspiratorySideii.(1)Inputpower(a)Pneumatic:Compressedmedicalgasesareused astheenergysourceVolumetricDiffusiveRespirator(VDR®)Designedspecificallyforhospitaluse,theVolumetricDiffusiveRespiratorunit(VDR®-4)isaflowregulatedandtime-cycledventilatorwhichprovideshigh-frequencypercussiveventilation(HFPV)WhatisVDR?VDR,VolumetricDiffusiveRespiration,isa pneumaticallydrivenpressure-limitedandtime-cycledventilatorthatprovideshigh-frequencypercussiveventilation(HFPV)FiltrationivItrepresentsthetotal pressureneededtopushavolumeofgasintothelungandiscomposedofpressuresresultingoxygenation(ECMO)andhigh-frequencyventilationoffer opportunitiesforlungprotectiveventilationwhilstminimisingrheotraumaresultingfromeitherexcessivecyclicvolumeoscillationsorrepeatedre-inflationof atelectaticairspaces.Understandingyourventilatorcircuiti.ExpiratorySideiii.Thismodeofventilationisprovidedsolelybythevolumetricdiffusiverespirator (VDR)Allcontraindicationsrelatingtotrach-positiveventilatorsapplyThemodeofventilation,circuittype,andalarmstrategiesshouldbechosenafteraclinical evaluationofeachpatient’sneedsExploreSentec’sTCMandEITtechnologytoimproveclinicalision-makingApnoeaventilationVolumeandpressureVolume andpressurePresetprogramsPRESSURERANGEANDSETTINGSDeliveredpressure(cmHO)2–(leakcircuit)0–(valvecircuit)2–(leakcircuit)Delivered tidalvolume(cmHO)AdulttomLPaediatrictomLAdulttomLRespiratoryrateAdult:Off,tobpm•Thedevicecanprovidetherapiestypicallyassociatedwithboth ventilator-dependentandnon-dependentpatientsThedevicemustnotbeusedatanaltitudeaboveft(m)oroutsidethetemperatureintheVDR-4@ventilator,a flight-approvedaircompressor(Aeridyne@MedicalAirCompressor,TimeterInstrumentCorp,StLouis,MO)isusuallyrequisitionedfortheflightIn mechanicalventilation,thepressuregradientresultsfromincreased(positive)pressureoftheairsource.Thebasicbuildofamechanicalventilatorcanbedescribed accordingto(1)inputpower,(2)sourceofpressurisedgas,(3)drivemechanism,or(4)controlcircuitHumidificationSystem1High-FrequencyPercussive VentilationRevisitedPeakairwaypressureismeasuredattheairwayopening(Pao)andisroutinelydisplayedbymechanicalventilatorsPatrickFAllan,MD,* ErikCOsborn,MD,*KevinKChung,MD,†SandraMWanek,MD*High-frequencypercussiveventilation(HFPV)hasdemonstratedapotentialroleasa rescueoptionforrefractoryacuterespiratorydistresssyndromeandasamethodforimprovinginhala-tioninjuryoutcomesAbstract