Effectiveness of high-frequency jet ventilation in management of an experimental bronchopleural fistula

M. Barringer, J. Meredith, Donald Prough, R. Gibson, R. Blinkhorn

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

An animal model was prepared to compare the effectiveness of high-frequency jet ventilation (HFJV) with that of conventional intermittent positive pressure ventilation (IPPV) in managing bronchopleural fistula. In ten adult beagles, the left upper pulmonary lobe was resected and the left upper lobe bronchus was cannulated to establish a permanent bronchopleural fistula. Apposition of the middle lobe to the chest wall was examined via an open thoracotomy. Fistula leakage was measured with the thoracotomy closed, and chest tube drainage was set at 20 cm H 2O. With HFJV, lung apposition was attained at lower peak (8.9 cm H 2 O) and expiratory (5.7 cm H 2O) pressures than with IPPV (21.2 cm H 2O peak pressure and 10.7 cm H 2O expiratory pressure). With equivalent arterial blood gases, fistula leakage was 47 per cent higher with IPPV than with HFJV (P < .001). Each 5 cm of positive end expiratory pressure (PEEP) added increased fistula leakage similarly to both systems. Varying the frequency of HFJV did not alter leakage significantly, but increasing the driving pressure markedly increased leakage. Thus, experimentally, HFJV proved superior to IPPV in the management of bronchopleural fistula. When HFJV is used clinically to manage a bronchopleural fistula, the driving pressure should be kept as low as possible and PEEP should be limited. The ventilatory rate may be varied to achieve the desired PaCO 2 without significantly affecting leakage through the fistula.

Original languageEnglish (US)
Pages (from-to)610-613
Number of pages4
JournalAmerican Surgeon
Volume48
Issue number12
StatePublished - 1982
Externally publishedYes

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High-Frequency Jet Ventilation
Fistula
Intermittent Positive-Pressure Ventilation
Pressure
Positive-Pressure Respiration
Thoracotomy
Chest Tubes
Lung
Thoracic Wall
Bronchi
Drainage
Animal Models
Gases

ASJC Scopus subject areas

  • Surgery

Cite this

Effectiveness of high-frequency jet ventilation in management of an experimental bronchopleural fistula. / Barringer, M.; Meredith, J.; Prough, Donald; Gibson, R.; Blinkhorn, R.

In: American Surgeon, Vol. 48, No. 12, 1982, p. 610-613.

Research output: Contribution to journalArticle

Barringer, M, Meredith, J, Prough, D, Gibson, R & Blinkhorn, R 1982, 'Effectiveness of high-frequency jet ventilation in management of an experimental bronchopleural fistula', American Surgeon, vol. 48, no. 12, pp. 610-613.
Barringer, M. ; Meredith, J. ; Prough, Donald ; Gibson, R. ; Blinkhorn, R. / Effectiveness of high-frequency jet ventilation in management of an experimental bronchopleural fistula. In: American Surgeon. 1982 ; Vol. 48, No. 12. pp. 610-613.
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