Volume-controlled high frequency positive pressure ventilation for upper abdominal surgery. A clinical report

Area of Science:

• Anesthesiology
• Respiratory Physiology
• Surgical Procedures

Background:

• Intermittent positive pressure ventilation (IPPV) is a standard ventilation method during anesthesia.
• High-frequency positive pressure ventilation (HFPPV) is an alternative technique with potential benefits.
• Evaluating HFPPV's efficacy and safety in surgical patients is crucial.

Purpose of the Study:

• To compare HFPPV with IPPV in patients undergoing biliary tract surgery.
• To assess HFPPV's effectiveness in morbidly obese patients during gastric stapling.
• To explore HFPPV's utility in intraoperative conditions and during emergence from anesthesia.

Main Methods:

• A comparative study involving 74 patients undergoing biliary tract surgery comparing HFPPV and IPPV.
• Application of HFPPV in 8 morbidly obese patients during gastric stapling.
• Evaluation of HFPPV during spontaneous breathing for intermittent mandatory ventilation.

Main Results:

• No significant differences in oxygenation or ventilation between HFPPV and IPPV.
• HFPPV demonstrated significantly lower airway pressures and tidal volumes.
• Adequate oxygenation and ventilation were achieved in obese patients; a quiet operative field was noted.
• Superimposing HFPPV on spontaneous breathing reduced hypoxia risk during emergence and suctioning.

Conclusions:

• HFPPV is a viable alternative to IPPV for biliary tract surgery, offering lower airway pressures.
• HFPPV is effective in morbidly obese patients and can improve the surgical environment.
• HFPPV as intermittent mandatory ventilation enhances safety during anesthesia emergence and tracheal suctioning.