Low frequency oscillatory ventilation through the suction channel of a pediatric bronchoscope

To determine whether low frequency oscillatory ventilation (LFOV) may be safely applied through the suction channel of a pediatric fiberoptic bronchoscope, we devised a system using a combination of jet ventilation and constant air suction, both delivered with a single interface valve. The system was tested on an in vitro lung model and on rabbits. With tidal volumes of 12 mL, inadvertent increase in functional residual capacity (FRC) measured in the lung model was minimal. All rabbits experienced marked hypoventilation (PaCO2 62 +/- 2 torr) on introduction of the bronchoscope, which promptly improved with administration of LFOV (PaCO2 41 +/- 4 torr). That baseline FRC remained stable indicated that air trapping did not occur. We conclude that LFOV improves ventilation in rabbits during bronchoscopy without causing air trapping. A similar system might be applied during bronchoscopy in full-term and premature infants, thus facilitating safer and more complete visualization of their airways and preserving the possibility of obtaining samples by suction.