現行呼吸管理法に不応な呼吸不全患者でのHigh Frequency Oscillationの効用

High frequency oscillation for respiratory failure unresponsive to the current respiratory management

　High frequency oscillation （HFO）法は呼吸の既存概念とは著しく異なった呼吸法であり，俄かには受け入れ難い概念である。さらにその有効性の是非や方法論の未確立がその受け入れを困難にしており，臨床での使用には大きな制約がある。しかし，本報告では従来の呼吸管理の方法でぱ呼吸不全に改善がみられなかった5例にHFOを試み，1例で著効をみ，3例で寛解をみる成績をえたので報告する。

　HFO法の評価または資料の一助となれば幸甚と思い，ここに報告するとともに，皆様のご批判をあおぎたい。

High frequency oscillation (HFO) was employed in 5 patients who had been suffered from acute respiratory failure and were unresponsive to the current management for respiratory failure. The failure was improved remarkably in one patients with pulmonary and 80% surface burn, and remit-ted in three patients. In the latter three two were post-operative failure and the one was pneumonia. HFO was used either alone or by superimposing on the controlled respiration. Oscillation ranged from 3 to 14 Hz with a range of driving pressure from 0.3 to 2.0 kg/cm². The following results were obtained:

1) There was no optimal setting of HFO, frequency and driving pressure, to obtain the im-provement of the failure. Namely, the current hy-pothesis that greater the frequency better the oxy-genation and reverse for CO₂ elimination was not confirmed in the patients with respiratory failure.

2) Several hours were necessary to obtain an improvement in the failed lung.

3) HFO should be initiated as early as possible.