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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004613nam a2200421 4500
001oai:DiVA.org:uu-229033
003SwePub
008140728s2014 | |||||||||||000 ||eng|
020 a 9789155489847q print
024a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2290332 URI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a vet2 swepub-contenttype
072 7a dok2 swepub-publicationtype
100a Sütterlin, Robert,d 1981-u Uppsala universitet,Anestesiologi och intensivvård4 aut0 (Swepub:uu)roble593
2451 0a Jet Ventilation for Airway Surgery :b The Influence of Mode and Frequency on Ventilation Efficacy
246a Jet ventilation vid luftvägskirurgi :b Betydelse av ventilationsmode och frekvens for ventilationens effektivitet
264 1a Uppsala :b Acta Universitatis Upsaliensis,c 2014
300 a 62 s.
338 a electronic2 rdacarrier
520 a 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.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Anestesi och intensivvård0 (SwePub)302012 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Anesthesiology and Intensive Care0 (SwePub)302012 hsv//eng
653 a jet ventilation
653 a airway obstruction
653 a tracheal stenosis
653 a HFJV
653 a SHFJV
653 a Anestesiologi och intensivvård
653 a Anaesthesiology and Intensive Care
700a Frykholm, Peter,c associate professoru Uppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet4 ths
700a Larsson, Anders,c professoru Uppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet4 ths
700a Johan, Ullman,c associate professoru Karolinska Institutet, Institutionen för fysiologi och farmakologi (FYFA), Anestesiologi och intensivvård, Stockholm4 opn
710a Uppsala universitetb Anestesiologi och intensivvård4 org
856u https://uu.diva-portal.org/smash/get/diva2:735634/FULLTEXT01.pdfx primaryx Raw objecty fulltext
856u https://uu.diva-portal.org/smash/get/diva2:735634/PREVIEW01.jpgx Previewy preview image
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-229033

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