This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Goto, K. Articles by Arakawa, K. Search for Related Content PubMed PubMed Citation Articles by Goto, K. Articles by Arakawa, K.

Efficacy of High-Frequency Jet Ventilation in Cardiac Tamponade

Department of Anesthesiology, The University of Kansas Medical Center, Kansas City, Kansas.

Abstract

To evaluate the effects of high-frequency jet ventilation (HFJV) (f = 60, 120 breaths/min) and conventional mechanical ventilation (CMV) (f = 10, 20) during equivalent conditions of cardiac tamponade, stroke index (SI), intra-pericardial pressure (IPP), airway pressure (P_aw), and cardiac pressures were measured in anesthetized, paralyzed, chest-closed dogs with the same levels of Paco₂ Cardiac tamponade was produced by infusing normal saline into the intrapericardial space to increase IPP to either 8 mm Hg (group 1, n = 8) or 12 mm Hg (group 2, n = 8). Stroke index in group 1 was 7.3±0.8 during CMV (f = 10), 8.1 ± 0.7 during CMV (f = 20), 10.9 ± 1.4 during HFJV (f= 60), and 10.7 ± 1.2 (mL·beat ^–1· m^–2) during HFJV (f = 120). Stroke index in group 2 was 4.1 ± 0.7, 5.1 ± 0.5, 7.2 ± 0.5, and 6.7 ± 0.5 (mL·beat^–1·m^–2), respectively. In both IPP groups, stroke index values during HFJV were significantly higher than during CMV; however, there were no significant differences in mean left and right atrial transmural pressures between HFJV and CMV. Peak IPP, mean P_aw, and peak P_aw during HFJV were significantly lower than those during CMV. The results indicate that HFJV with lower mean and peak P_aw, and with lower mean and peak IPP, can result in higher cardiac output than CMV in cardiac tamponade. Thus, HFJV may be superior to CMV in the clinical management of cardiac tamponade.

Key Words: HEART, TAMPONADE—ventilation. • VENTILATION, HIGH-FREQUENCY JET.