{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:19:02Z","timestamp":1770142742029,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:00:00Z","timestamp":1555459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The carbon dioxide (CO<jats:sub>2<\/jats:sub>) diffusion coefficient (DCO\n<jats:sub>2<\/jats:sub>) reflects CO\n<jats:sub>2<\/jats:sub> removal during high\u2010frequency oscillatory ventilation (HFOV). We hypothesized that despite leak flow during noninvasive HFOV (nHFOV) DCO\n<jats:sub>2<\/jats:sub> continues to indicate ventilation efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A neonatal airway model including CO<jats:sub>2<\/jats:sub> production and an adjustable oropharyngeal leak was connected to a ventilator via bi\u2010nasal prongs. Pressures and gas flows were measured at prongs, trachea, and leak. Oscillatory tidal volumes below (<jats:italic>V<\/jats:italic>\n<jats:sub>T trachea<\/jats:sub>) and above the leak (<jats:italic>V<\/jats:italic>\n<jats:sub>T prong<\/jats:sub>) were calculated from tracheal and leak flows. DCO\n<jats:sub>2<\/jats:sub> was calculated using <jats:italic>V<\/jats:italic>\n<jats:sub>T trachea<\/jats:sub> (DCO\n<jats:sub>2 trachea<\/jats:sub>) and <jats:italic>V<\/jats:italic>\n<jats:sub>T prong<\/jats:sub> (DCO\n<jats:sub>2 prong<\/jats:sub>) and compared with CO\n<jats:sub>2<\/jats:sub> partial pressure (pCO\n<jats:sub>2<\/jats:sub>). Effects of leak flow (0, 5, or 10\u00a0L\/min) on DCO\n<jats:sub>2<\/jats:sub> were assessed at fixed pressure amplitudes or predefined oscillatory volumes under steady\u2010state pCO\n<jats:sub>2<\/jats:sub> conditions in the modeled lung.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DCO<jats:sub>2 trachea<\/jats:sub> correlated strongly with pCO\n<jats:sub>2<\/jats:sub>, independent of the leak flow level (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). DCO\n<jats:sub>2 prong<\/jats:sub> correlated with pCO\n<jats:sub>2<\/jats:sub> without and with moderate leak (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) but not with maximum leak (<jats:italic>P<\/jats:italic>\u2009=\u20090.1432). <jats:italic>V<\/jats:italic>\n<jats:sub>T trachea<\/jats:sub> correlated with the quotient of tracheal pressure amplitude and frequency irrespective of the leak (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Based on the pressure amplitude at prong level (<jats:italic>A<\/jats:italic>\n<jats:sub>prong<\/jats:sub>) <jats:italic>V<\/jats:italic>\n<jats:sub>T trachea<\/jats:sub> continued to follow a linear model of which the slopes decreased with increasing leak flow. <jats:italic>V<\/jats:italic>\n<jats:sub>T prong<\/jats:sub> correlated with the quotient of <jats:italic>A<\/jats:italic>\n<jats:sub>prong<\/jats:sub> and frequency, irrespective of the leak (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>DCO<jats:sub>2<\/jats:sub> obtained at the airway opening at prong level reflects ventilation efficacy during nHFOV even in the presence of moderate oropharyngeal leak.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24333","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T04:06:38Z","timestamp":1555560398000},"page":"759-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Carbon dioxide diffusion coefficient in noninvasive high\u2010frequency oscillatory ventilation"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8957-7196","authenticated-orcid":false,"given":"Christoph","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Medical Center\u00a0\u2014\u00a0University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany"},{"name":"Department of Cardiology and Cardiovascular Medicine University Hospital of T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Schumann","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Medical Center\u00a0\u2014\u00a0University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Center for Pediatrics, Medical Center\u00a0\u2014\u00a0University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Klotz","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Center for Pediatrics, Medical Center\u00a0\u2014\u00a0University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,17]]},"reference":[{"key":"e_1_2_8_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24120"},{"key":"e_1_2_8_1_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2008.00900.x"},{"key":"e_1_2_8_1_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2017-313190"},{"key":"e_1_2_8_1_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.79.1.F61"},{"key":"e_1_2_8_1_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2011.580401"},{"key":"e_1_2_8_1_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23755"},{"key":"e_1_2_8_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.05.029"},{"key":"e_1_2_8_1_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23534"},{"key":"e_1_2_8_1_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1651-9"},{"key":"e_1_2_8_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2008.05.002"},{"key":"e_1_2_8_1_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1989.66.3.1343"},{"key":"e_1_2_8_1_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22511"},{"key":"e_1_2_8_1_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000431216"},{"key":"e_1_2_8_1_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23824"},{"key":"e_1_2_8_1_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-018-0138-6"},{"key":"e_1_2_8_1_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-014-2419-y"}],"container-title":["Pediatric 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