Abstract
The first objective of this study was to determine if leakage (V) through a pneumothorax and chest tube of infants with pulmonary disease is less during high frequency jet ventilation. (HFJV) than during conventional ventilation (CV). We measured V in 5 infants, who had chest tubes placed to relieve tension pneumothoraces while managed alternately on CV and HFJV. In all infants, V was less during HFJV than CV (49±26 vs 157±81 ml/min, mean±SE). However, we also noticed that significantly lower mean tracheal airway pressure (Ptaw) were used during HFJV than CV (9±1 vs 15±2 cm H2O, p<0.01). PaCO2 was also less (35±8 vs 45±9 mmHg; p<0.03) although PaO2 values were not significantly different. We then turned to an animal model of RDS to determine the effects of Ptaw and mode of ventilation on V. In 9 saline lavaged cats we induced pneumothoraces by application of high airway pressures. First we adjusted CV and HFJV settings so that Ptaw was lower during HFJV; we then adjusted the ventilators to produce similar Ptaw. When Ptaw was lowered from 13±0.3 (CV) to 10±0.5 cm H2O (HJFV), V decreased significantly (p<0.01) from 651±86 to 294±84 ml/min. When Ptaw was held constant (12.7±1 cm H2O) mean V values were identical 489±100 ml/min and arterial blood gases were also unaltered. These results suggest that HFJV may be used to reduce the rate of pulmonary air leakage in infants with pulmonary diseases and that reduced Ptaw is the cause of the reduced V.
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Gonzalez, F., Harris, T., Richardson, P. et al. 181 HIGH FREQUENCY JET VENTILATION REDUCES AIR LEAKAGE FROM PNEUMOTHORACES OF INFANTS AND ANIMALS. Pediatr Res 19, 141 (1985). https://doi.org/10.1203/00006450-198504000-00211
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DOI: https://doi.org/10.1203/00006450-198504000-00211
