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Simulation of ventilatory-induced stone movement and its effect on stone fracture during extracorporeal shock wave
J P Whelan1, N Gravenstein, J L Welch
1Department of Surgery, University of Florida College of Medicine, Gainesville.
Abstract:
Because ventilation influences renal movement, we investigated the effect of stone motion on the efficiency of extracorporeal shock-wave lithotripsy (ESWL). Comparisons of the rates of fragmentation of an experimental model of renal calculi were made between simulated high-frequency jet ventilation at 100 breaths/min. with four-mm. stone movement as measured from the fluoroscope screen, conventional mechanical ventilation at 10 breaths/min. with 32-mm. stone movement as measured from the fluoroscope screen, and a static control. Fragmentation did not differ significantly between high-frequency jet ventilation and no ventilation (static control), but was significantly greater with high-frequency jet ventilation than with conventional ventilation.