Effect of mechanical load on tidal volume during high-frequency jet ventilation

1988 ◽  
Vol 64 (3) ◽  
pp. 1217-1222 ◽  
Author(s):  
G. G. Berdine ◽  
P. J. Strollo
Keyword(s):  
High Frequency ◽  
Mechanical Load ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Jet Ventilation ◽  
Mechanical Loads ◽  
High Frequency Jet Ventilation ◽  
Arterial Blood ◽  
Frequency Independent ◽  
Load Conditions

High-frequency jet ventilation (HFJV) was studied in twelve deeply anesthetized, paralyzed dogs. Entrained volume and total expired volume were directly measured by integration of flow. Jet volume was computed from these measurements. Seven dogs were ventilated with a driving pressure of 10 psi at rates of 2 and 5 Hz for each of three mechanical loads: control, thoracoabdominal wrap, and histamine infusion. Both load conditions reduced total expired volume and entrained volume but had no effect on jet volume. Wrap reduced entrainment more at 2 Hz while the effect of histamine infusion was frequency independent. Control arterial blood gases demonstrated that PO2 was higher and PCO2 was lower during 2 Hz ventilation than during 5 Hz ventilation despite equivalent minute volumes. Five additional dogs were studied using control and wrap loads and an additional ventilator setting of 15 psi at 5 Hz. This group demonstrated that wrap reduces entrainment more at lower frequencies for ventilatory settings providing equivalent gas exchange. We conclude that increasing mechanical load reduces entrainment during HFJV and that this reduction is frequency dependent for restrictive loads.

Influence of Tracheal Obstruction on the Efficacy of Superimposed High-frequency Jet Ventilation and Single-frequency Jet Ventilation

2015 ◽  
Vol 123 (4) ◽  
pp. 799-809 ◽  
Author(s):  
Robert Sütterlin ◽  
Antonella LoMauro ◽  
Stefano Gandolfi ◽  
Rita Priori ◽  
Andrea Aliverti ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Chest Wall ◽  
High Frequency ◽  
Blood Gases ◽  
Single Frequency ◽  
Jet Ventilation ◽  
Lung Volumes ◽  
High Frequency Jet Ventilation ◽  
Tracheal Obstruction

Abstract Background: Both superimposed high-frequency jet ventilation (SHFJV) and single-frequency (high-frequency) jet ventilation (HFJV) have been used with success for airway surgery, but SHFJV has been found to provide higher lung volumes and better gas exchange than HFJV in unobstructed airways. The authors systematically compared the ventilation efficacy of SHFJV and HFJV at different ventilation frequencies in a model of tracheal obstruction and describe the frequency and obstruction dependence of SHFJV efficacy. Methods: Ten anesthetized animals (weight 25 to 31.5 kg) were alternately ventilated with SHFJV and HFJV at a set of different fHF from 50 to 600 min−1. Obstruction was created by insertion of interchangeable stents with ID 2 to 8 mm into the trachea. Chest wall volume was measured using optoelectronic plethysmography, airway pressures were recorded, and blood gases were analyzed repeatedly. Results: SHFJV provided greater than 1.6 times higher end-expiratory chest wall volume than HFJV, and tidal volume (VT) was always greater than 200 ml with SHFJV. Increase of fHF from 50 to 600 min−1 during HFJV resulted in a more than 30-fold VT decrease from 112 ml (97 to 130 ml) to negligible values and resulted in severe hypoxia and hypercapnia. During SHFJV, stent ID reduction from 8 to 2 mm increased end-expiratory chest wall volume by up to 3 times from approximately 100 to 300 ml and decreased VT by up to 4.2 times from approximately 470 to 110 ml. Oxygenation and ventilation were acceptable for 4 mm ID or more, but hypercapnia occurred with the 2 mm stent. Conclusion: In this in vivo porcine model of variable severe tracheal stenosis, SHFJV effectively increased lung volumes and maintained gas exchange and may be advantageous in severe airway obstruction.

scholarly journals High Frequency Jet Ventilation during Initial Management, Stabilization, and Transport of Newborn Infants with Congenital Diaphragmatic Hernia: A Case Series

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Qianshen Zhang ◽  
Jason Macartney ◽  
Lita Sampaio ◽  
Karel O'Brien
Keyword(s):  
High Frequency ◽  
Rescue Therapy ◽  
Newborn Infants ◽  
Vital Signs ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Blood Gases ◽  
Jet Ventilation ◽  
High Frequency Jet Ventilation ◽  
Significant Difference

Objective. To review experience of the transport and stabilization of infants with CDH who were treated with high frequency jet ventilation (HFJV).Study Design. Retrospective chart review was performed of infants with antenatal diagnosis of CDH born between 2004 and 2009, at Mount Sinai Hospital Toronto, Ontario, Canada. Detailed information was abstracted from the charts of all infants who received HFJV.Results. Of the 55 infants, 25 were managed with HFJV at some point during resuscitation and stabilization prior to transport. HFJV was the initial ventilation mode in six cases and nineteen infants were placed on HFJV as rescue therapy. Blood gases procured from the umbilical artery before and/or after the initiation of HFJV. There was a significant difference detected for both PaCO2(P=0.0002) and pH (P<0.0001). The pre- and posttransport vital signs remained stable and no transport related deaths or significant complications occurred.Conclusion. HFJV appears to be safe and effective providing high frequency rescue therapy for infants with CDH failing conventional mechanical ventilation. This paper supports the decision to utilize HFJV as it likely contributed to safe transport of many infants that would not otherwise have tolerated transport to a surgical centre.

scholarly journals High frequency jet ventilation through mask contribute to oxygen therapy in patients undergoing bronchoscopic intervention under deep sedation

2020 ◽  
Author(s):  
Mingyuan Yang ◽  
Bin Wang ◽  
Qingwu Hou ◽  
Yunzhi Zhou ◽  
Na Li ◽  
...  
Keyword(s):  
High Frequency ◽  
Oxygen Therapy ◽  
Deep Sedation ◽  
Blood Gas ◽  
Jet Ventilation ◽  
Arterial Blood Gas ◽  
Airway Stenosis ◽  
High Frequency Jet Ventilation ◽  
Arterial Blood ◽  
Procedure Duration

Abstract Background: High frequency jet ventilation (HFJV) is an open ventilating technique to maintain ventilation for emergency or difficult airway. However, it is unclear whether jet ventilation or conventional oxygen therapy (COT) is more effectively and safely to maintain adequate oxygenation in patients with airway stenosis during bronchoscopic intervention (BI) under deep sedation.Methods: A prospective randomized cohort study was conducted to compare HFJV with normal frequency jet ventilation (NFJV) and COT (high flow oxygen) in oxygen supplementation during BI under deep sedation from March 2020 to August 2020. Patients receiving BI under deep sedation were randomly divided into 3 parallel groups of 50 patients each: the COT group (FiO21.0, 12 L/min), the NFJV Group (FiO2 1.0, driving pressure 0.1MPa, respiratory rate (RR) 15bpm) and HFJV Group (FiO2 1.0, driving pressure 0.1MPa, RR 1200bpm). SpO2, MBP and HR were recorded during the whole procedure. Arterial blood gas was examined and recorded at 15 minutes after initiation of procedure. Procedure duration, dose of anesthetics and adverse events during BI in the three groups were also recorded.Results: A total of 161 patients were enrolled with 11 patients excluded. Clinical characteristics were similar among the three groups. PaO2 of HFJV group was significantly higher than that of COT and NFJV group (P<0.001). PaO2 was significantly correlated with ventilation mode (P<0.001), BMI (P=0.019) and procedure duration (P=0.001). Multiple linear regression showed that only BMI and procedure duration were independent influencing factors of arterial blood gas PaO2 (P=0.040, P=0.002). The location of airway lesions and severity of airway stenosis were no statistical correlation with PaCO2 and PaO2.Conclusions: HFJV can effectively and safely improve intra-operative PaO2 in patients with airway stenosis during BI in deep sedation, and doesn’t increase intra-operative PaCO2 and the risk of hypercapnia. The location of airway lesions and severity of airway stenosis may not affect oxygenation maintain during basic and some advanced BI.Trial registration: Chinese Clinical Trial Registry. Registration number, ChiCTR2000031110, registered on March 22, 2020.

Carboxyhaemoglobin levels, pulse oximetry, and arterial blood gases during jet ventilation for Nd-YAG laser bronchoscopy

1990 ◽  
Vol 4 (6) ◽  
pp. 2
Author(s):  
D.R. Goldhill ◽  
A.J. Hill ◽  
R.H. Whitburn ◽  
R.O. Feneck ◽  
J. George ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Jet Ventilation ◽  
Yag Laser ◽  
Arterial Blood

Neonatal High-Frequency Jet Ventilation: Four Years' Experience

PEDIATRICS ◽  
1985 ◽  
Vol 75 (4) ◽  
pp. 657-663 ◽  
Author(s):  
Stephen J. Boros ◽  
Mark C. Mammel ◽  
J. Michael Coleman ◽  
Patrick K. Lewallen ◽  
Margaret J. Gordon ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Frequency ◽  
Jet Ventilation ◽  
Arterial Blood Gas ◽  
High Frequency Jet Ventilation ◽  
Air Leaks ◽  
Relative Risks ◽  
Arterial Blood ◽  
End Stage ◽  
Necrotizing Tracheobronchitis

During a 4-year period, 34 neonates were treated with high-frequency jet ventilation (HFJV) using two different HFJV systems. Twenty-three of the neonates had severe pulmonary air leaks, five had congenital left-sided diaphragamatic hernias, and six had end-stage respiratory failure without pulmonary air leaks. The two HFJV systems performed similarly in all pathologic conditons. Following HFJV, arterial blood gas values improved in 28 of the 34 patients (82%). Eleven patients (32%) ultimately survived. Of 23 patients with pulmonary air leaks, 17 (74%) improved, nine (39%) survived. One infant with diaphragmatic hernia and one with end-stage respiratory failure survived. Ten of 12 patients (85%) who died following eight or more hours of HFJV had significant tracheal histopathology in the region of the endotracheal tube tip. The lesions ranged from moderate erythema to severe necrotizing tracheobronchitis with total tracheal obstruction. HFJV can be useful in the treatment of severe pulmonary air leaks in neonates and may prove useful in the treatment of congenital diaphragmatic hernias. However, HFJV produces inflammatory injuries in the proximal trachea. More clinical and laboratory studies are needed to define the relative risks and benefits of this new therapy.

Venturi Jet Ventilation through the Metal Endotracheal Tube: A Nonflammable System

1983 ◽  
Vol 92 (4) ◽  
pp. 405-407 ◽  
Author(s):  
Peak Woo ◽  
M. Stuart Strong
Keyword(s):  
Adverse Effects ◽  
Endotracheal Tube ◽  
Direct Laryngoscopy ◽  
Reliable Method ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Jet Ventilation ◽  
Safe Method ◽  
Arterial Blood ◽  
Laser Excision

In an effort to design a fireproof and reliable method of ventilation during CO2 laser laryngoscopies, a new Venturi jet endotracheal tube coupler has been designed. This allows microdirect laryngoscopy. Its design features are described. Sixteen clinical cases of various laryngeal pathologies treated with direct laryngoscopy and laser excision are ventilated using this system. The clinical data and experiences are discussed. The arterial blood gases done at 20 minutes after muscular paralysis showed a median value of pH 7.45/PO2 252/PCO2 36. No complications or adverse effects were noted. The Venturi jet endotracheal tube coupler allows for jet ventilation through a metal endotracheal tube with reliable ventilation. This is an alternate, reliable, and fire-safe method during laser use.

scholarly journals Specific changes in the partial pressure of arterial blood carbon dioxide observed during high-frequency jet ventilation in dogs.

1989 ◽  
Vol 51 (3) ◽  
pp. 646-648
Author(s):  
Hiromitsu ORIMA ◽  
Akihito NOTO ◽  
Tadashi KOIZUMI ◽  
Makoto WASHIZU ◽  
Masahiro TAGAWA ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
High Frequency ◽  
Jet Ventilation ◽  
High Frequency Jet Ventilation ◽  
Arterial Blood
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