High frequency positive pressure ventilation (HFPPV) has been used clinically for bronchoscopy, laryngoscopy, prolonged respiratory support, and management of bronchopleural fistula. This report describes three cases in which HFPPV was used to successfully ventilate patients during lobectomy. A fluidic logic-controlled ventilator with rates of 60-150 breaths/min provided adequate gas exchange for these patients with open chests. In one case this also included successful ventilation during a brief period of 4 minutes when the left upper-lobe bronchus was open. The minimal lung movement during HFPPV was found to provide excellent operating conditions for the surgeons and adequate gas exchange without cardiovascular embarrassment.
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