Abstract
High airway pressure during assisted ventilation may impair cardiac function. Because adequate gas exchange may be accomplished at lower airway pressures with HFJV, we compared cardiac function during conventional(volume) ventilation(CV) with that during 1–3 hours of HFJV(frequency 150–200/min, I:E 1:3–1:6). CO(L/min/m2) was determined by thermodilution, in triplicate, in 8 patients aged 2 mos.-7 yrs. on the 1st to 3rd day following correction of congenital heart disease. Heart rate(HR), central venous(CVP), pulmonary artery(PAP), left atrial(LAP), mean blood (HBP) and distal endotracheal tube pressures including peak inspiratory(PIP), positive end expiratory(PEEP) and mean airway pressures(Paw) were continuously monitored. Blood gases from CVP, PAP and LAP lines were obtained. No patient had evidence of intracardiac shunting or pulmonary regurgitation.
CVP, PAP, LAP, pCO2,pH and HCO3 were comparable during both CV and HFJV. Despite the decreased PaO2 during HFJV, O2 delivery (cardiac index X O2 content) did not change (256±150ml/min/m2 to 263±136). We conclude that post-cardiac surgery HFJV increased CO and maintains comparable ventilation at reduced PIP, PEEP and Paw. HFJV may be advantageous in patients with cardiovascular compromise by allowing for improvement in cardiac hemodynamics.
Supported by ALA of Ohio, ALANO
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Weiner, J., Chatburn, R., Carlo, W. et al. 222 INCREASED CARDIAC OUTPUT(CO) DURING HIGH-FREQUENCY JET VENTILATION(HFJV). Pediatr Res 19, 147 (1985). https://doi.org/10.1203/00006450-198504000-00252
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DOI: https://doi.org/10.1203/00006450-198504000-00252