Jet ventilation dynamics in rigid bronchoscope: insights from a simulated experimental model

Area of Science:

• Anesthesiology
• Respiratory Physiology
• Medical Engineering

Background:

• Jet ventilation is crucial for airway management during rigid bronchoscopy.
• Current intraoperative management relies on SpO2 and blood gas analysis due to limited flow dynamics data.
• Objective data on jet ventilation parameters is needed for optimizing patient care.

Purpose of the Study:

• To investigate the impact of different jet ventilation modes (NFJV, HFJV, SHFJV), driving pressure, and frequency on airflow dynamics.
• To analyze peak airway pressure (Ppeak), positive end-expiratory pressure (PEEP), and tidal volume (Vt) in a simulated airway model.
• To provide data for optimizing ventilation strategies in rigid bronchoscopy.

Main Methods:

• Utilized a 3D-printed rigid bronchoscope and artificial airway model.
• Integrated a jet ventilator, airflow analyzer, and test lung for data acquisition.
• Measured Ppeak, PEEP, and Vt under varying ventilation modes, driving pressures, and frequencies.

Main Results:

• Increasing frequency generally decreased Ppeak and Vt while increasing PEEP.
• Higher driving pressure increased Ppeak, PEEP, and Vt across all modes.
• NFJV delivered higher Vt at lower frequencies; HFJV showed lower Vt at high frequencies; SHFJV demonstrated dynamic Vt ranges with pressure adjustments.

Conclusions:

• NFJV provides larger tidal volumes, whereas HFJV may lead to CO2 retention.
• SHFJV offers a potential solution for complex airway management by combining benefits of both modes.
• Individualized selection of ventilation parameters based on airway mechanics is essential for safe and effective patient care.