3100B initial clinical guidelines
These guidelines are recommendations only and are
based on data collected from trials with the CareFusion
3100B HFOV, and assume the clinician has read and
understands the 3100B operator’s manual. The physician
must determine appropriateness of these guidelines as
they apply to specific patients.
Initiating HFOV
1. Set initial mPaw approximately 5 cmH
2
O above the
conventional ventilator mPaw.
a. Consider a recruitment maneuver first if patient
is extremely hypoxemic.
b. If oxygenation worsens, increase mPaw in
3 to 5 cmH
2
O increments every 30 minutes.
c. Check a chest x-ray within 4 hours to assess
lung volume.
2. Set power at 4.0 and quickly adjust to achieve desired chest wiggle (visual
vibration from shoulders to mid-thigh area).
a. Transcutaneous monitoring for PCO
2
should be considered.
b. If PaCO
2
worsens (but pH > 7.2), increase the power setting to achieve a
change of amplitude in 10 cmH
2
O pressure increments every 30 minutes up
to a maximum setting. If increasing the amplitude, frequency or IT% does
not result in a significant decrease in PaCO
2
, strongly consider assessing lung
volume (mPaw).
c. If pH is < 7.2, consider buffering pH.
d. An abrupt rise in PaCO
2
in an otherwise stable patient should be considered
an obstruction of the endotracheal tube, until proven otherwise.
3. Set frequency in the range of 5 to 6 Hz initially.
a. Decrease the frequency if hypercapnea persists despite increases in amplitude
and confirmation of adequate lung volume.
b. Decrease the frequency by 1 Hz at a time every 30 minutes until you reach a
level of 3 Hz.
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