May 1988

Ultra—High-Frequency Jet Ventilation in a Bronchopleural Fistula Model

Author Affiliations

From the Department of Surgery (Drs Orlando and Cohen) and Division of Pulmonary Medicine (Drs Gluck and Mesologites), Hartford (Conn) Hospital; and Department of Surgery, University of Connecticut School of Medicine, Farmington (Drs Orlando and Cohen).

Arch Surg. 1988;123(5):591-593. doi:10.1001/archsurg.1988.01400290073012

• High-frequency ventilation techniques have been demonstrated to be useful in decreasing gas loss from bronchopleural fistulas. We performed the present study to evaluate the impact of a new jet ventilator design and ventilatory frequency on hemodynamics, gas exchange, and bronchialstump gas flow in an animal model of bronchopleural fistula. Ten pigs underwent a right-sided thoracotomy and right-sided upper pulmonary lobectomy with cannulation of the upper lobe bronchus for measurement of bronchial fistula flow rate. Animals underwent a random sequence of conventional ventilation (12 to 20 breaths per minute), conventional high-frequency jet ventilation (120 breaths per minute), and ultra—high-frequency jet ventilation (UHFJV; 450 breaths per minute). Hemodynamic measurements were similar in the three ventilatory modes, but oxygenation was best with UHFJV. Bronchial fistula flow was lowest with UHFJV and greatest with conventional ventilation. Ultra—high-frequency jet ventilation demonstrated superior oxygen loading, adequate carbon dioxide elimination, and the least flow through the fistula, suggesting that both ventilator design and frequency are important therapeutic variables in the management of major airway disruption.

(Arch Surg 1988;123:591-593)