Dynamic hyperinflation : Comparison of jet ventilation versus conventional ventilation in patients with severe end-stage obstructive lung disease

Positive pressure ventilation in patients with obstructive lung disease may result in over-inflation of the relatively compliant lungs, resulting in dynamic hyperinflation (DHI). Using a crossover trial design, we compared high-frequency jet ventilation (HFJV) versus "optimal" intermittent...

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Bibliographic Details
Published in:Anaesthesia and intensive care 1997-10, Vol.25 (5), p.471-475
Main Authors: MYLES, P. S, EVANS, A. B, MADDER, H, WEEKS, A. M
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Pressure
Carbon Dioxide - blood
Cardiac Output
Cross-Over Studies
Emergency and intensive respiratory care
Female
High-Frequency Jet Ventilation
Humans
Intensive care medicine
Intermittent Positive-Pressure Ventilation
Lung - physiopathology
Lung Compliance - physiology
Lung Diseases, Obstructive - physiopathology
Lung Diseases, Obstructive - surgery
Lung Diseases, Obstructive - therapy
Lung Transplantation
Male
Medical sciences
Middle Aged
Positive-Pressure Respiration, Intrinsic - physiopathology
Positive-Pressure Respiration, Intrinsic - prevention & control
Prospective Studies
Pulmonary Diffusing Capacity - physiology
Single-Blind Method
Stroke Volume
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Summary:Positive pressure ventilation in patients with obstructive lung disease may result in over-inflation of the relatively compliant lungs, resulting in dynamic hyperinflation (DHI). Using a crossover trial design, we compared high-frequency jet ventilation (HFJV) versus "optimal" intermittent positive pressure ventilation (IPPV) in ten patients undergoing lung transplantation for severe, end-stage obstructive lung disease. We measured haemodynamics and the degree of DHI after both modes of ventilation. There were no significant differences between IPPV and HFJV, with respect to efficiency of ventilation (PaCO2), haemodynamic effects (stroke volume, blood pressure and cardiac output), or lung hyperinflation (trapped gas volume). This study suggests that HFJV, when compared with optimal IPPV, is no better at minimizing DHI in patients with severe, end-stage obstructive lung disease.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057x9702500503