The Annals of Thoracic Surgery, Vol 37, 491-496, Copyright © 1984 by The Society of Thoracic Surgeons
Gas exchange and facilitation of high-frequency ventilation in intrathoracic surgery
S Seki, K Goto, T Kondo, Y Fukushima, H Konishi and F Kosaka
High-frequency ventilation (HFV) of the jet type was evaluated for
facilitation of intrathoracic operations because HFV does not necessitate
ventilatory movement of the lung and reduces the volume of the lung. The
feasibility of HFV as a substitute for the current respiratory management
of intermittent positive-pressure ventilation (IPPV) was determined in 12
patients with cancer of the lung by employing two types of HFV-HFV alone
(Group 1) and HFV on physiological dead-space volume (VD) (Group 2). For
the 6 patients in Group 1, HFV was set at a frequency of 3 Hz and a driving
pressure of 0.5 kg/cm2. For the 6 patients in Group 2, HFV was set at 6 Hz
with the same driving pressure but was superimposed on a small tidal volume
equal to a dead space. High-frequency ventilation facilitated intrathoracic
operations because of the disappearance of ventilatory movement and the
reduced volume. No significant difference between the groups was found for
arterial oxygen tension. Arterial carbon dioxide tension (PaCO2) in
patients in Group 1 remained in the normal range, although it was slightly
acidotic. The PaCO2 in Group 2 was acidotic. Therefore, it was concluded
that HFV alone can be substituted for IPPV in gas exchange and provides
good accessibility to the operative field.
