High-frequency jet ventilation versus conventional ventilation after surfactant displacement in dogs

High-frequency jet ventilation (HFJV) was compared with conventional ventilation (CV) after surfactant displacement with diocytyl sodium sulfosuccinate (OT) via ultrasonic nebulization. After aerosol delivery, dogs were separated into 3 groups and followed for 2 h. Ventilator settings were not changed in group I (CV) and group II (HFJV) after OT delivery. In group III, drive pressure was increased to 40 psi. Adequacy of oxygenation varied directly with peak inspiratory pressure (PIP) rather than airway pressure (Paw) in both HFJV and CV. In all groups, immediately after OT administration PaO2 decreased and there was a slight increase in Paw; PIP was significantly elevated only in groups I and III. Two hours later, PaO2 had returned to baseline in groups I and III, but had not improved significantly in group II. Paw remained the same in all groups. These data demonstrate that in noncompliant lungs, oxygenation is not improved unless a high PIP is used to establish the critical opening pressures needed to rerecruit alveoli. In this noncompliant lung model, HFJV was not effective at low Paw values, and thus offered no apparent advantage over CV.