Three modes of low-compression open systems are currently being used for high frequency ventilation (HFV): (1) insufflation catheter or double-lumen tube, (2) pneumatic valve, and (3) jet injector nozzle. Using two different ventilators—a Bronchovent and a Corning fluidic model—we studied these three systems in seven anesthetized dogs and in a lung model. In two modes of HFV (high frequency positive-pressure ventilation [HFPPV] and high frequency jet ventilation [HFJV]), the dogs were ventilated to normocarbia with a frequency of 60/min and an inspiratory time of 22% of the ventilatory cycle. There were no resulting differences in variables associated with circulation and oxygen transport. There were few differences in end-inspiratory airway pressures between the two ventilators or among the three modes of ventilation. There were no differences in tidal volume. The pneumatic valve system (without air entrainment) provided the highest peak inspiratory flow. No air entrainment was associated with use of the double-lumen tube either. With the jet injector nozzle technique, air entrainment contributed 26% of the tidal volume with the Bronchovent ventilator and 58% with the Corning ventilator. These open systems cannot provide preset tidal volumes, which would be optimal for patient safety. Optimal ventilator design in HFV demands systems that can provide volume-controlled ventilation.
SjostrandUH, BuneginL, SmithRB, BabinskiMF. Development and clinical application of high frequency ventilation. In: ScheckPAE, SjostrandUH, SmithRB, eds. Perspectives in high frequency ventilation. The Hague: Martinus Nijhoff Pub! BY, 1983;12–38.
2.
BabinskiMF, SjostrandUH, SmithRB, BuneginL.Animal and lung model studies of double-lumen tracheal tubes for high frequency ventilation. Respir Care1983;28:754–760.
3.
JonzonA, ObergPA, SedinG, SjostrandU.High frequency positive-pressure ventilation by endotracheal insufflation. Acta Anaesthesiol Scand [Suppl] 1971;43:1–43.
4.
SjostrandU.Review of the physiological rationale for and development of high-frequency positive-pressure ventilation—HFPPV. Acta Anaesthesiol Scand [Suppl] 1977;64:7–27.
5.
SjostrandU.High frequency positive pressure ventilation (HFPPV): A review. Crit Care Med1980;8:345–364.
6.
SjostrandU.Pneumatic systems facilitating treatment of respiratory insufficiency with alternative use of IPPV/PEEP, HFPPV/PEEP, CPPV, or CPAP. Acta Anaesthesiol Scand [Suppl] 1977;64:123–147.
7.
SjostrandUH, KollerME, SmithRB, BreivikH, BuneginL.IPPV, HFPPV, and HFPPV/PEEP in dogs with acute cardiac tamponade. Respir Care1983;28:767–773.
DixonWJ, BrownM, eds. Biomedical computer programs P-series. Berkeley: University of California Press, 1979.
10.
SjostrandUH, WattwilLM, BorgUR, BerggrenLE. Volume-controlled high-frequency positive-pressure ventilation as a useful mode of ventilation during open-chest surgery—A report of three cases. Respir Care1982;27:1380–1385.
11.
SchusterDP, KlainM, SnyderJV. Comparison of high frequency jet ventilation to conventional ventilation during severe acute respiratory failure in humans. Crit Care Med1982;10:625–630.
12.
BorgU, ErikssonI, SjöstrandU, WattwilM.Experimental studies of continuous positive-pressure ventilation and high-frequency positive-pressure ventilation. Resuscitation1981;9:1–21.
13.
WattwilLM, SjöstrandUH, BorgUR. Comparative studies of IPPV and HFPPV with PEEP in critical care patients. I: A clinical evaluation. Crit Care Med1983;11:30–37.
14.
BorgU, LyttkensL, NilssonL-G, SjöstrandU.Physiologic evaluation of the HFPPV pneumatic valve principle and PEEP—An experimental study. Acta Anaesthesiol Scand [Suppl] 1977;64:37–53.
15.
BorgU, ErikssonI, LyttkensL, NilssonL-G, SjöstrandU.High-frequency positive-pressure ventilation (HFPPV) applied in bronchoscopy under general anaesthesia—An experimental study. Acta Anaesthesiol Scand [Suppl] 1977;64:69–81.
16.
SmithRB, SjöstrandUH, eds. High frequency ventilation. International Anesthesiology Clinics. Volume 21, Number 3. Boston: Little, Brown & Co, 1983.
17.
SjöstrandUH, SmithRB. Development and clinical application of low-compression ventilation. Opusc Med (in press).
18.
WattwilLM, SjöstrandUH, BorgUR, ErikssonIA. Comparative studies of IPPV and HFPPV with PEEP in critical care patients. II: Studies on intrapulmonary gas distribution. Crit Care Med1983;11:38–43.
