Efficacy of Superimposed High Frequency Jet Ventilation and High Frequency Jet Ventilation in an Animal Model of Tracheal Obstruction
2014 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175Article in journal (Refereed) Submitted
Superimposed high frequency jet ventilation (SHFJV) and high-frequency jet ventilation (HJFV) are widely used for airway interventions using rigid bronchoscopy. SHFJV was found to provide higher lung volume and better gas exchange than HFJV in unobstructed airways.
We hypothesized that, also in the presence of airway obstruction, SHFJV would provide higher lung volumes, better oxygenation and more effective CO2 removal than HFJV.
In a porcine model, we used a stent with ID 4 mm to create tracheal obstruction. The anesthetized animals (25-31.5kg) were alternately ventilated with SHFJV (low frequency 16min-1, combined with a high frequency fHF) and HFJV (solely fHF) at a set of different fHF from 50-600min-1. Chest wall volume changes were measured with opto-electronic plethysmography, airway pressures were registered continuously and arterial blood gases were obtained repeatedly.
SHFJV provided higher ∆EEVCW than HFJV with a difference between both modes of 129 ml (fHF=50min-1) to 62 ml (fHF=400min-1). Tidal volume (VT) was always greater than 213 ml with SHFJV, but with HFJV, increasing fHF reduced VT from 112 (97-130) ml at fHF=50 min-1 to negligible values at fHF>150 min-1.
In analogy, SHFJV provided paO2 of >30 kPa and acceptable CO2 removal for all fHF, whereas fHF>150 min-1 resulted in severe hypoxia and hypercarbia during HFJV.
SHFJV effectively increased lung volumes and maintained gas exchange compared with HFJV. SHFJV may be a safer option than HFJV in laser surgery, where low FiO2 is required. HFJV with frequencies >100-150 min-1 should not be used in severe airway obstruction.
Place, publisher, year, edition, pages
jet ventilation, airway obstruction, tracheal stenosis, HFJV, SHFJV
Anesthesiology and Intensive Care
Research subject Anaesthesiology and Intensive Care
IdentifiersURN: urn:nbn:se:uu:diva-229060OAI: oai:DiVA.org:uu-229060DiVA: diva2:735504
FunderSwedish Research CouncilSwedish Heart Lung Foundation