Document Detail


Factors influencing pulmonary volumes and CO2 elimination during high-frequency jet ventilation.
MedLine Citation:
PMID:  3931506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An external spirometric method using a differential linear transformer was used to measure tidal volume (VT) and to determine factors influencing CO2 elimination and HFJV-induced "PEEP effect" in 15 critically ill patients under HFJV. VT increased with increasing driving pressure (DP) and decreasing frequency (f) and was influenced little by changes in I/E ratio. CO2 elimination, as reflected by the measurement of PaCO2, was mainly influenced by the absolute level of VT rather than by the product VT X frequency (PaCO2 = 5715/VT, r = 0.75, P less than 0.05). The primary phenomenon explaining HFJV-induced "PEEP effect" was intrapulmonary gas trapping due to incomplete exhalation of the first VT administered: the spontaneous relaxation times of these first VT were longer than expiratory time allotted to the ventilatory settings. HFJV-induced "PEEP effect" increased with I/E ratio, DP, and f and was markedly influenced by the mechanical properties of the total respiratory system. At given ventilatory settings, HFJV-induced "PEEP effect" was greater in patients with a normal or elevated time constant of the total respiratory system (tau RS) than in patients with a low tau RS. These results suggest that HFJV should not be used in patients with chronic obstructive pulmonary disease and asthma, and should be preferentially administered to patients having stiff lungs or decreased chest wall compliance.
Authors:
J J Rouby; G Simonneau; D Benhamou; R Sartene; F Sardnal; H Deriaz; P Duroux; P Viars
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  63     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1985 Nov 
Date Detail:
Created Date:  1985-11-21     Completed Date:  1985-11-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  473-82     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carbon Dioxide / physiology*
Humans
Lung Volume Measurements*
Middle Aged
Respiration*
Respiration, Artificial* / methods
Respiratory Insufficiency / physiopathology,  therapy
Spirometry / methods
Tidal Volume*
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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