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Ann Thorac Surg 1981;32:468-474
© 1981 The Society of Thoracic Surgeons

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Articles

High-Frequency Jet Ventilation in Major Airway or Pulmonary Disruption

From the Departments of Critical Care and Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY

^* Address reprint requests to Dr. Turnbull, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021

High-frequency jet ventilation is an experimental method of mechanical support, which achieves satisfactory alveolar ventilation and oxygenation at low peak-inspiratory pressures of 5 to 8 cm H₂O and low end-expiratory pressures of 3 to 5 cm H₂O. This characteristic was used to advantage in 23 patients with cancer, 12 of whom had tracheal or bronchial disruption complicated by pneumonia. Eight patients who could not be supported by conventional means were salvaged.

Barotrauma complicated the very high peak airway pressures required to ventilate 8 of 11 patients with respiratory failure associated with diffuse interstitial pneumonia or pulmonary fibrosis. There were only 2 survivors despite temporary normalization of arterial blood gas values in 7 patients.

Earlier use of high-frequency jet ventilation in patients with poor compliance may prevent pulmonary disruption in addition to deleterious hemodynamic and systemic effects of conventional high-pressure ventilation. Other applications under study include the role of jet ventilation in resection of the trachea or carina, and in major airway trauma.

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