scholarly journals High frequency jet ventilation through mask contribute to oxygen therapy among 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, whether jet ventilation or conventional oxygen therapy (COT) is more effectively and safe in maintaining adequate oxygenation, is unclear among 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 (fractional inspired oxygen (FiO2) of 1.0, 12 L/min), the NFJV group (FiO2 of 1.0, driving pressure of 0.1MPa, and respiratory rate (RR) 15bpm) and the HFJV Group (FiO2 of 1.0, driving pressure of 0.1MPa, and RR of 1200bpm). Pulse oxygen saturation (SpO2), mean blood pressure and heart rate were recorded during the whole procedure. Arterial blood gas was examined and recorded 15 minutes after the procedure was initiated. The 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. The clinical characteristics were similar among the three groups. The PaO2 of the HFJV group was significantly higher than that of the COT and NFJV groups (P<0.001). PaO2 was significantly correlated with ventilation mode (P<0.001), body mass index (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 and P=0.002, respectively). The location of airway lesions and the severity of airway stenosis were not statistically correlated with PaCO2 and PaO2.Conclusions: HFJV could effectively and safely improve the intra-operative PaO2 among patients with airway stenosis during BI in deep sedation, and it did not increase the intra-operative PaCO2 and the risk of hypercapnia. The location of airway lesions and the severity of airway stenosis may not affect oxygenation maintenance during basic and some advanced BI.

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.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingyuan Yang ◽  
Bin Wang ◽  
Qingwu Hou ◽  
Yunzhi Zhou ◽  
Na Li ◽  
...  
Keyword(s):  
High Frequency ◽  
Deep Sedation ◽  
Blood Gas ◽  
Ventilation Mode ◽  
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, whether jet ventilation or conventional oxygen therapy (COT) is more effective and safe in maintaining adequate oxygenation, is unclear among patients with airway stenosis during bronchoscopic intervention (BI) under deep sedation. Methods A prospective randomized cohort study was conducted to compare COT (high flow oxygen) with normal frequency jet ventilation (NFJV) and HFJV 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 (fractional inspired oxygen (FiO2) of 1.0, 12 L/min), the NFJV group (FiO2 of 1.0, driving pressure of 0.1 MPa, and respiratory rate (RR) 15 bpm) and the HFJV Group (FiO2 of 1.0, driving pressure of 0.1 MPa, and RR of 1200 bpm). Pulse oxygen saturation (SpO2), mean arterial blood pressure and heart rate were recorded during the whole procedure. Arterial blood gas was examined and recorded 15 min after the procedure was initiated. The 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. The clinical characteristics were similar among the three groups. PaO2 of the COT and NFJV groups was significantly lower than that of the HFJV group (P < 0.001). PaO2 was significantly correlated with ventilation mode (P < 0.001), body mass index (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 and P = 0.002, respectively). The location of airway lesions and the severity of airway stenosis were not statistically correlated with PaCO2 and PaO2. Conclusions HFJV could effectively and safely improve intra-operative PaO2 among patients with airway stenosis during BI in deep sedation, and it did not increase the intra-operative PaCO2 and the risk of hypercapnia. PaO2 was correlated with ventilation mode, BMI and procedure duration. Only BMI and procedure duration were independent influencing factors of arterial blood gas PaO2. PaCO2 was not correlated with any preoperative factor. Trial registration Chinese Clinical Trial Registry. Registration number, ChiCTR2000031110, registered on March 22, 2020.

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.

scholarly journals How to treat patients with acute respiratory failure? Conventional oxygen therapy versus high-flow nasal cannula in the emergency department

2019 ◽  
pp. 102490791988624
Author(s):  
Mustafa Gedikloglu ◽  
Muge Gulen ◽  
Salim Satar ◽  
Yahya Kemal Icen ◽  
Akkan Avci ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
Vital Signs ◽  
High Flow ◽  
Nasal Cannula ◽  
Blood Gas ◽  
High Flow Nasal Cannula ◽  
Arterial Blood Gas ◽  
Arterial Blood

Objective: To investigate whether high-flow nasal cannula oxygen therapy could reduce the rate of endotracheal intubation and improve arterial blood gas values, vital signs, and clinical outcomes of patients with hypoxemic acute respiratory failure as compared with conventional oxygen therapy alone. Methods: This retrospective, observational study was performed in the 15-month study period and included adult patients with tachypnea and hypoxemia, whose vital signs and arterial blood gas were monitored. The high-flow nasal cannula oxygen group consisted of patients admitted to the emergency department with acute respiratory failure when high-flow nasal cannula oxygen treatment was available in the hospital, while the conventional oxygen therapy group consisted of patients who have presented to the emergency department with acute respiratory failure in the absence of high-flow nasal cannula oxygen device in the hospital. The primary outcome of the study was improvement in vital signs and arterial blood gas values within first and fourth hours of the treatment. The second outcome was the need for intubation in the emergency department, length of hospital stay, and hospital mortality. Results: The decrease in the pulse and respiratory rate of high-flow nasal cannula oxygen–treated group was significantly greater than the conventional oxygen therapy group on the first and fourth hours of treatment (p < 0.001). PaO2 values were significantly higher in the high-flow nasal cannula oxygen group at the first and fourth hours of treatment (p ⩽ 0.001). Likewise, mean SaO2 levels of patients receiving high-flow nasal cannula oxygen treatment was significantly higher than those of patients in the conventional oxygen therapy group (p = 0.006 at 1 h and p < 0.001 at 4 h). In the hypercapnic patients, the decrease in PaCO2 and increase in pH and PaO2 values were significantly greater in high-flow nasal cannula oxygen group (p < 0.001). The difference between the groups regarding the need for invasive mechanical ventilation was not statistically significant (p = 0.179). Conclusion: High-flow nasal cannula oxygen treatment has been associated with favorable effects in vital signs and arterial blood gas values in patients with acute respiratory failure. High-flow nasal cannula oxygen might be considered as the first-line therapy for patients with hypoxemic and/or hypercapnic acute respiratory failure.

Carboxyhemolobin Concentrations, Pulse Oximetry and Arterial Blood Gas Tensions During Jet Ventilation for Nd-YAG Laser Bronchoscopy

1992 ◽  
Vol 36 (1) ◽  
pp. 6
Author(s):  
D. R. GOODHILL ◽  
A. J. HILL ◽  
R. H. WHITBURN ◽  
R. O. FENECK ◽  
P. J. M. GEORGE ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Blood Gas ◽  
Jet Ventilation ◽  
Yag Laser ◽  
Arterial Blood Gas ◽  
Arterial Blood
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