JET VENTILATION USING LOW OR HIGH FREQUENCIES, DURING BRONCHOSCOPY

Abstract

Jet ventilation, through a bronchoscope, was evaluated using a lung model (normal compliance and increased airway resistance). Three I/E ratios (0.25, 0.43, 0.67) and seven rates of ventilation (from 20 to 230 cycles per min (c min-1) were studied with the bronchoscope either unoccluded or partially occluded by a telescope. Increases in I/E ratio induced increases in minute ventilation, peak airway pressure, end-expiratory pressure and lung volume. Increase in the rate of ventilation decreased peak airway pressure, increased end-expiratory pressure and lung volume; minute ventilation increased in parallel with the increase in the rate of ventilation or remained constant when a high I/E ratio was used. The introduction of the telescope reduced minute ventilation, as a result of a decrease in the amount of air entrained, and increased end-expiratory pressure and lung volume. The risk of barotrauma as a result of high peak pressure is reduced during high frequency jet ventilation, but the increase in lung volume, particularly when the telescope is introduced, may be of clinical importance.