Measurement of tidal volume during high-frequency jet ventilation

The measurement of tidal volume during high-frequency jet ventilation is difficult due to the high-frequency components of the inspiratory flow. To validate tidal volume measured with a screen pneumotachograph placed on the expiratory limb, we simultaneously determined tidal volume with a body plethysmograph in seven anesthetized normal adult New Zealand rabbits before and after saline lung lavage. Four to six comparisons of tidal volume were obtained by varying peak inspiratory pressures at each combination of frequency (120, 240, and 480/min) and inspiratory to expiratory time ratio (1:1, 1:3, 1:5, 1:9). Overall, 90% of the tidal volumes measured with the pneumotachograph were within 10% of 1 ml of the volumes determined with the plethysmograph, independent of frequency, inspiratory to expiratory time ratio, and lung compliance. There was unidirectional outward flow at the pneumotachograph during inspiration when both normal and saline lavaged lungs were being ventilated, suggesting a lack of gas entrainment. We conclude that a pneumotachograph on the expiratory limb may be used to measure tidal volume and gas entrainment in vivo during high-frequency jet ventilation. Determination of tidal volume may serve to optimize ventilator settings during high-frequency jet ventilations and facilitate an understanding of the mechanism involved in gas exchange.