Jet Ventilation for Airway Surgery: The Influence of Mode and Frequency on Ventilation Efficacy

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Sütterlin, Robert,1981-Uppsala universitet,Anestesiologi och intensivvård (författare)

Jet Ventilation for Airway Surgery : The Influence of Mode and Frequency on Ventilation Efficacy

BokEngelska2014

Förlag, utgivningsår, omfång ...

Uppsala :Acta Universitatis Upsaliensis,2014
62 s.
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:uu-229033
ISBN:9789155489847
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-229033URI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:vet swepub-contenttype
Ämneskategori:dok swepub-publicationtype

Varianttitlar

Jet ventilation vid luftvägskirurgi :Betydelse av ventilationsmode och frekvens for ventilationens effektivitet

Anmärkningar

In surgery for airway obstruction, the anesthetist and the ear-nose-throat surgeon share the approach to the airway and jet ventilation (JV) is a mutually convenient ventilation technique for both parties. As a consequence of the open system jet ventilation is applied in, bedside measurements of lung volumes are cumbersome to perform and thus, there is a lack of studies comparing different modes of JV or investigating the influence of ventilator settings on lung volumes and gas exchange. In this thesis, single frequency jet ventilation and superimposed high frequency jet ventilation (SHFJV) at different frequencies are systematically compared with respect to lung volume changes, underlying airway pressure variations and the resulting gas exchange.We compared three single-frequency JV modalities with SHFJV in patients. Moreover, we performed a systematic investigation of single frequency JV and SHFJV in a porcine model. Single frequency JV and SHFJV were compared frequency-wise in intact airways and in a newly developed model of tracheal obstruction. This model was also used to assess the influence of variable airway diameter on ventilation effectiveness during SHFJV. We measured chest wall volume variations with opto-electronic plethysmography and obtained airway pressures as well as gas exchange parameters.In unobstructed airways, both single-frequency JV and SHFJV provided adequate oxygenation, despite differences in lung volumes. Carbon dioxide removal was most effective using single frequency JV at a frequency of 150 min-1. During SHFJV, for both intact and obstructed airways, the choice of frequency for the high frequency component had little influence on lung volumes, airway pressures and gas exchange. With decreasing airway diameter and SHFJV, we observed air trapping and lower tidal volumes and acceptable oxygenation. Carbon dioxide removal, however, was insufficient at the narrowest airway diameter. In single frequency JV, very high frequencies resulted in negligible tidal volume and inacceptable gas exchange. Airway obstruction potentiated this frequency dependence.In conclusion, in intact airways, single frequency JV at sufficiently low frequencies provided adequate oxygenation and better CO2 removal than SHFJV. With decreasing airway diameter, SHFJV provided better oxygenation and CO2 removal and may therefore be the mode of choice in more complicated cases.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
jet ventilation
airway obstruction
tracheal stenosis
HFJV
SHFJV
Anestesiologi och intensivvård
Anaesthesiology and Intensive Care

Biuppslag (personer, institutioner, konferenser, titlar ...)

Frykholm, Peter,associate professorUppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet (preses)
Larsson, Anders,professorUppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet (preses)
Johan, Ullman,associate professorKarolinska Institutet, Institutionen för fysiologi och farmakologi (FYFA), Anestesiologi och intensivvård, Stockholm (opponent)
Uppsala universitetAnestesiologi och intensivvård (creator_code:org_t)

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Av lärosätet: Uppsala universitet

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