Driving pressure and arterial carbon dioxide tension during high-frequency jet ventilation in postoperative patients.

Abstract:

:To achieve normocarbia during conventional mechanical ventilation, ventilator settings are determined initially on the basis of body weight. The best ventilator settings for CO2 elimination during high-frequency jet ventilation (HFJV) have not been so clearly defined. A recent study has suggested that eucarbia will be obtained with HFJV when tidal volume (VT) per kg of body weight is kept within a narrow, well-defined range. In the same study, a "bench test" demonstrated that VT was directly proportional to the jet ventilator driving pressure (DP). The goal of our study was to confirm this recommended VT/kg to obtain eucarbia and to determine whether the relation observed between VT and DP in the laboratory was true clinically. We studied 14 patients admitted to the ICU for postoperative support. We determined a good correlation between DP and VT/kg (r = .811, p less than .001) for the group as a whole and a good inverse correlation between DP or VT/kg and PaCO2 for most individual patients; however, there was a poor inverse correlation between DP or VT/kg and PaCO2 for the group as a whole, due to wide patient-to-patient variation in the efficiency of jet ventilation. We conclude that there is no universal formula for setting jet ventilator DP or VT/kg to affect normocarbia in humans.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Bayly R,Sladen A,Tyler IL,Echegaray RF,Klain M,Guntupalli K

doi

10.1097/00003246-198801000-00012

subject

Has Abstract

pub_date

1988-01-01 00:00:00

pages

58-61

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

16

pub_type

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