Abstract
HFJV has been reported to reduce airway pressures during assisted ventilation in preterm infants. Nonetheless, augmented pressure transmission to alveoli has been observed at frequencies near resonance. We determined the effect of surfactant deficiency on airway to alveolar pressure transmission in 6 postmortem adult rabbit lungs (3 normal and 3 surfactant-deficient by multiple saline lavage) during both conventional ventilation (CV, f=30/min, rectangular wave) and HFJV (f=200/min, triangular wave). Alveolar pressure was measured via a piezoelectric transducer on the visceral pleura and communicating with the alveoli. Airway pressure was measured with a similar transducer and/or catheter, both inside the distal endotracheal tube. With each ventilator, measurements were obtained maintaining either peak inspiratory pressure(PIP 20-30cmH2O), positive end expiratory pressure(PEEP 3-13cmH2O) or ΔP(PIP-PEEP 7-27cmH2O) constant. During CV the ratios of alveolar to airway PIP, PEEP and ΔP were always 1.0, while during HFJV they ranged from 0.9 to 1.1. Alveolar to airway pressure ratios were not affected by saline lavage and were independent of magnitude or combination of pressures used. We conclude that in this rabbit model of normal and surfactant-deficient lungs, airway pressures are transmitted to the alveoli with little distortion during HFJV at the frequencies employed. Thus, the previously reported reduction in airway pressures during HFJV may in fact portend decreased barotrauma at the alveolar level. Supported by ALA-Ohio
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Carlo, W., Chatburn, R., Teeter, J. et al. ALVEOLAR PRESSURES DURING HIGH-FREQUENCY JET VENTILATION(HFJV) IN NORMAL AND SURFACTANT-DEFICIENT LUNGS. Pediatr Res 18 (Suppl 4), 388 (1984). https://doi.org/10.1203/00006450-198404001-01768
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DOI: https://doi.org/10.1203/00006450-198404001-01768