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Anesth Analg 1987; 66:833-838
© 1987 International Anesthesia Research Society
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Comparison of High-Frequency Jet Ventilation with Conventional Mechanical Ventilation for Bronchopleural Fistula

Michael J. Bishop, MD, Michael S. Benson, BS, RRT, Patricia Sato, MD, and David J. Pierson, MD

Received from the Departments of Anesthesiology, Medicine (Divisions of Pulmonary and Critical Care Medicine), and Respiratory Therapy, Harborview Medical Center and the University of Washington School of Medicine, Seattle, Washington.

Abstract

In seven patients with acute respiratory failure and a bronchopleural fistula, the authors compared gas exchange and volume of gas lost via the chest tube during conventional mechanical ventilation (CV) and high-frequency jet ventilation (HFJV). After the initial comparison, patients were randomized to HFJV or CV, unless one mode of ventilation was clearly superior based on preestablished criteria. In six of the seven patients, oxygenation deteriorated after the switch from CV to HFJV. The ratio of PaCO2 to FIO2 declined from 227 ± 167 to 133 ± 100 (mean ± SD, P > 0.05), and the Paco2 increased from 47 ± 13 to 56 ± 18 mm Hg (P > 0.05). The mean chest tube leak did not change significantly. Randomization of the mode of ventilation was not performed in any patient because CV was superior by a priori criteria. We conclude that when acute respiratory failure is complicated by a bronchopleural fistula, HFJV with mean airway pressures comparable to those provided during conventional ventilation does not provide satisfactory gas exchange.

Key Words: VENTILATION—high frequency, intermittent positive pressure breathing




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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 © 1987 by the International Anesthesia Research Society.