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Anesth Analg 1984; 63:19-24
© 1984 International Anesthesia Research Society
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Impact of Changes in Operating Pressure during High-Frequency Jet Ventilation

D. Benhamou, MD, C. Ecoffey, MD, J. J. Rouby, MD, J. Fusciardi, MD, and P. Viars, MD

Recieved from the Département d'Anesthésie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Abstract

Fifteen critically ill patients with acute respiratory failure were ventilated with high-frequency jet ventilation (HFJV; frequency 100 breaths/min; I/E ratio 0.43; 1.8-mm internal diameter injector cannula). The patients were divided into two groups according to their initial Pao2 during intermittent positive pressure ventilation at FIO21: in eight patients (group I) the mean Pao2 was 141 ± 34 mm Hg, and in seven patients (group II) mean Pao2 was 376 ± 75 mm Hg. During HFJV three different operating pressures were used at random: 1.3,1.8, and 2.3 bars. Increase in operating pressures significantly decreased Paco2 and significantly increased mean lung volume above apneic FRC, mean airway pressure, and mean alveolar pressure in both groups. A close relationship was found between variations in mean airway pressure and mean alveolar pressure (r = 0.99, P < 0.001). Significant increases in Pao2 with increasing operating pressures were observed only in group I. In group II, Paco2 was significantly lower than in group I for a given operating pressure. We conclude that operating pressure is a main determinant of arterial oxygenation during HFJV because of the concomitant increases in intrathoracic pressures and lung volume. Operating pressure also influences carbon dioxide clearance, Paco2 varies inversely with operating pressure.

Key Words: VENTILATION—high-frequency






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1984 by the International Anesthesia Research Society.