[A comparison between high-frequency jet ventilation (HFJV) and conventional positive end-expiratory pressure...

In a controlled study on 24 dogs with severe damage to the lungs HFJV was compared to CPPV on the basis of selected cardiorespiratory parameters. The pulmonary damage was produced by injection of oleic acid (OA) into the right atrium under conventional mechanical ventilation (IPPV). After the damage, the dogs were randomly allotted into one of two groups. Twelve dogs (group I) were ventilated for 5 hours with a PEEP of 10 cm H2O (1 kPA), 12 animals (group II) for 5 hours with HFJV. The oleic-acid-induced damage results in the known hypoxaemia with an increase in the intrapulmonary shunt. After changing to CPPV, the PaO2, which fell from 27.2 +/- 3 kPa to 10.8 +/- 2.9 kPa, rises to 20.3 +/- 7.7 kPa, but shows no further significant alteration until the end of the experiment. In contrast to the clearly improved oxygenation, essential cardiocirculatory parameters (CI, SVI, RVSWI, LVSWI, TCO2) are partially reduced by more than 50% of the initial values. PAP, PCWP, HR, TPR and PVR increase significantly, MAP remaining nearly unchanged. After changeover to HFJV, there is first a further fall of PaO2 from 11.1. +/- 3.0 kPa to 9.1 +/- 1.4 kPa following OA, then, however, until the end of the experiment, a continuous elevation to 15.6 +/- 2.4 kPa with a mean airway pressure that is by 75% lower. The haemodynamic parameters show no significant changes as compared to the initial values, overall, however, they lie significantly below or above those of group I. The results from our investigations allow to draw the conclusion that, despite haemodynamic advantages, HFJV in consequence of deterioration of the arterial oxygenation currently is no alternative superior to CPPV in ventilating the severely damaged lung.