[Preliminary experiences with superimpoposed high-frequence jet ventilation in intensive care]

The study aimed to evaluate whether superimposed high-frequency jet ventilation (SHFJV) is a useful tool in intensive care medicine to ventilate patients with pulmonary insufficiency. METHODS. SHFJV is the simultaneous application of low- and high-frequency jet ventilation performed using a specially designed ventilator. SHFJV versus conventional mechanical ventilation (CMV) was were applied in three groups of patients. Group 1 (Gr 1) included patients without pulmonary insufficiency; group 2 (Gr 2) patients had moderate and those in group 3 (Gr 3) had severe pulmonary insufficiency. RESULTS. In Gr 1 and Gr 2, SHFJV was associated with a significant decrease in mean airway pressure (mPAW 12.9 vs. 13.3 mm Hg, P < 0.05). In Gr 3 oxygenation was significantly better with SHFJV (mean paO2 140.1 vs. 109.9 mm Hg, P < 0.05; mean FiO2 0.66 vs. 0.86, P < 0.05). Other parameters, such as maximum airway pressure (Pmax) and mean Paw, were significantly lower with SHFJV than CMV (mean Pmax 29.6 vs. 40.1 mm Hg, mean Paw 18 vs. 21.9 mm Hg, P < 0.05). Intrapulmonary shunt fractions showed a significant decrease with SHFJV (24.6 vs. 34.4, P < 0.05). CONCLUSIONS. Significant differences were observed primarily in Gr 3 patients, indicating that patients with severe pulmonary insufficiency may benefit from SHFJV. SHFJV may thus represent an alternative mode of ventilation in critically ill patients.