Airway pressure as a measure of gas exchange during high-frequency jet ventilation

Waterson, Charles K.; Militzer, Heinrich W.; Quan, Stuart F.; Calkins, Jerry M.

doi:10.1097/00003246-198409000-00012

Cited by 16 publications

(3 citation statements)

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“…Patients were divided into two groups according to the possibility of spontaneous ventilation. Indeed when a patient exhibits spontaneous ventilation during mechanical ventilation, intrathoracic and tracheal pressures are decreased and cardiac depression and [11] demonstrated that there were significant differences between airway pressures measured in the distal airway and those at the proximal end of the endotracheal tube. In our study airway pressure was recorded 10 cm distal to the tip of the injector cannula, as described by Carlon [3].…”

Section: Discussionmentioning

confidence: 99%

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

et al. 1987

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Sixteen patients with acute respiratory failure (ARF) were studied. In group I (12 patients, 15 explorations) patients were treated with continuous positive pressure ventilation (CPPV) during conventional ventilation (CV), pulmonary lesions (PL) were severe (Qsp/Qt = 0.24 +/- 0.16 with PEEP = 14 +/- 7 cm H2O) and high-frequency jet ventilation (HFJV) was performed without spontaneous ventilation (SV). In group II (5 patients, 12 explorations) patients were treated with intermittent mandatory ventilation (IMV) during CV, PL were moderate (Qsp/Qt = 0.13 +/- 0.05 with PEEP = 8 +/- 3 cm H2O) and HFJV was performed with SV. In both groups, frequency was 120 c/mn and I:E ratio = 1:2. The cannula size, the driving pressure and the PEEP (water column) were progressively adapted to obtain the same blood gases as those observed during CV, FIO2 being the same. Results on HFJV were compared to CV. In both groups there were no differences between PaCO2, PaO2, FIO2, Qsp/Qt during CV and HFJV. In group I peak airway pressure (PAWP), mean artery pressure (MAP), heart rate (HR), transmural mean pulmonary and wedge pressure (MPAPtm, PWPtm) were not different. Mean airway pressure (MAWP), PEEP and pleural pressure (PP) were higher, cardiac index (CI) was lower. In group II, PP, CI, MAP, HR, MPAPtm, MPWPtm were not different. PAWP was lower, MAWP and PEEP were higher. We conclude that during HFJV it is possible to obtain the same blood gas as during CV, but HFJV without CV may not be indicated in patients with severe PL, because circulatory impairment is higher.

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Section: Discussionmentioning

confidence: 99%

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

et al. 1987

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“…This is in accordance with results of other human studies using HFJV frequencies up to 200 b.p.m. [9,12,13]. This relationship suggests that a convective or axial flow transport mechanism, rather than an augmented dispersion, plays a major role in gas transport during HFJV at these frequencies of ventilation [14,15].…”

Section: Discussionmentioning

confidence: 91%

Predictive Value of FRC and Respiratory Compliance on Pulmonary Gas Exchange Induced by High Frequency Jet Ventilation in Humans

Pittet¹,

Morel²,

Bachmann³

et al. 1990

British Journal of Anaesthesia

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To determine if functional residual capacity (FRC), compliance of the respiratory system (C), or underlying pulmonary disease are predictive for the efficacy of high frequency jet ventilation (HFJV) on pulmonary gas exchange, we investigated six adult patients within 4 h of abdominal surgery and six patients with severe adult respiratory distress syndrome. Gas exchange during intermittent positive pressure ventilation (IPPV) was compared with that during HFJV at frequencies of 100 b.p.m. (HFJV100) and 200 b.p.m. (HFJV200), resulting in a minute ventilation of about 400 ml kg-1 with both ventilatory frequencies, and in both groups of patients. Baseline FRC and C were measured during IPPV with the multiple-breath nitrogen washout method and from expiratory pressure-volume curves, respectively. Changes in the alveolar-arterial oxygen difference (PAO2 - PaO2): FIO2 ratio induced by HFJV correlated negatively with C (HFJV100: r = -0.78, P less than 0.005; HFJV200: r = -0.84, P less than 0.005); that is, greater oxygenation was obtained in patients with a better compliance. Similarly, changes in arterial partial pressure of carbon dioxide (PaCO2) induced by HFJV correlated negatively with C (HFJV100: r = -0.77, P less than 0.001; HFJV200: r = -0.61, P less than 0.05). In contrast, there was no significant correlation between FRC measured during IPPV and changes in (PAO2 - PaO2): FIO2 ratio or PaCO2 induced by HFJV, as these changes were influenced more by the patient's pulmonary disease than by baseline FRC. These results should be interpreted in the context of different underlying pathophysiological mechanisms reducing FRC in both groups of patients.

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“…Unter den zahlreichen Monitorparametern im Rahmen einer High Frequency Jet-Ventilation (HFJV) kommt der Messung der Atemwegsdrücke nach den meisten Untersuchern eine wichtige Bedeutung zu (3,4,9,13,14,15,18,21). War in der Anfangszeit der Beschäftigung mit der HFJV vor allem der gegenüber herkömmlicher Beatmung geringere Atemwegs-Spitzendruck hervorgehoben worden, so wurde in den letzten Jahren zunehmend deutlicher, daß bei der HFJV für eine ausreichende Oxygenierung von Patienten mit pathologisch veränderten Lungen ein entsprechend hoher mittlerer Druck in den Atemwegen erforderlich ist, der den bei herkömmlicher Beatmung U. U. übersteigen muß (3,10,12,14,18).…”

Section: Introductionunclassified

Atemwegsdruck und transkutane O_2-und CO₂-Partialdrücke als Monitorgrößen für die High Frequency Jet-Ventilation?

Kluge¹,

Börner²,

Hempelmann³

1986

Anästhesiol Intensivmed Notfallmed Schmerzther

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Airway pressure as a measure of gas exchange during high-frequency jet ventilation

Cited by 16 publications

References 0 publications

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

Predictive Value of FRC and Respiratory Compliance on Pulmonary Gas Exchange Induced by High Frequency Jet Ventilation in Humans

Atemwegsdruck und transkutane O_2-und CO₂-Partialdrücke als Monitorgrößen für die High Frequency Jet-Ventilation?

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Airway pressure as a measure of gas exchange during high-frequency jet ventilation

Cited by 16 publications

References 0 publications

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

Comparison of high-frequency jet ventilation to conventional ventilation in adults with respiratory distress syndrome

Predictive Value of FRC and Respiratory Compliance on Pulmonary Gas Exchange Induced by High Frequency Jet Ventilation in Humans

Atemwegsdruck und transkutane O2-und CO2-Partialdrücke als Monitorgrößen für die High Frequency Jet-Ventilation?

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Atemwegsdruck und transkutane O_2-und CO₂-Partialdrücke als Monitorgrößen für die High Frequency Jet-Ventilation?