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.

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 Preliminary observations of the use of high-frequency jet ventilation as rescue therapy in infants with congenital diaphragmatic hernia

2010 ◽  
Vol 45 (4) ◽  
pp. 698-702 ◽  
Author(s):  
Michael A. Kuluz ◽  
P. Brian Smith ◽  
Sarah P. Mears ◽  
Jennifer R. Benjamin ◽  
Elisabeth T. Tracy ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
High Frequency ◽  
Rescue Therapy ◽  
Jet Ventilation ◽  
High Frequency Jet Ventilation

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.

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