Intrapulmonary Drug Administration during High Frequency Jet Ventilation

It has previously been demonstrated that high frequency jet ventilation, via transtracheal cricothyroid membrane puncture, can maintain good gas exchange even during cardiopulmonary resuscitation. When the upper airways were filled with fluid, aspiration could be prevented without a cuffed endotracheal tube when respiratory rates of 100/min or higher and an inspiratory time of at least 50% were used. We have also shown that cricothyroid membrane puncture is relatively easy to perform and produces less tracheal damage than a cuffed endotracheal tube.In one of our studies, cardio-green dye was mixed into the jet using a Y-connector on the proximal end of the angiocath cannula (Figure 1). In two dogs, the distribution of the dye in the lungs was investigated. It was found that nebulized dye was transported by the jet stream to the most distant bronchi which could be observed. On subsequent autopsy, the dye was found in the most peripheral airways.