High-frequency jet versus conventional ventilation in infants undergoing Blalock-Taussig shunts.
Nine infants undergoing modified Blalock-Taussig shunts were randomized to both high-frequency jet ventilation (HFJV) and conventional ventilation (CV). Vital signs, blood gases, mean airway pressure, lung mechanics, functional residual capacity, and lung movement were compared on both modes of ventilation keeping peak inspiratory and expiratory pressures constant. The mean airway pressure was lower on HFJV than on CV (8.5 versus 10.9 cm H2O). Arterial partial pressure of oxygen was greater on HFJV than on CV (55 versus 46 mm Hg), arterial partial pressure of carbon dioxide was lower on HFJV than on CV (28 versus 37 mm Hg), whereas compliance (0.54 versus 0.56 mL.cm H2O-1.kg-1). resistance (110 versus 95 cm H2O/L.s), and functional residual capacity (23 versus 22.5 mL/kg) remained the same. Lung movement and degree of retraction necessary for surgical exposure as evaluated by an independent observer was less with HFJV compared with CV. Compared with CV during the creation of Blalock-Taussig shunts, HFJV provides better gas exchange at lower mean airway pressure with similar lung function, lung volume, and hemodynamics.
Davis
D A
DA
Department of Anesthesia and Critical Care, St. Christopher's Hospital for Children, Temple University School of Medicine, Philadelphia, Pennsylvania.
Russo
P A
PA
Greenspan
J S
JS
Speziali
G
G
Spitzer
A
A
D000403:Airway Resistance; D000714:Anastomosis, Surgical; D001784:Blood Gas Analysis; D005652:Functional Residual Capacity; D006330:Heart Defects, Congenital / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D006611:High-Frequency Jet Ventilation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D008170:Lung Compliance; D011175:Positive-Pressure Respiration / Q000379:methods*; D011651:Pulmonary Artery / Q000601:surgery*; D011659:Pulmonary Gas Exchange; D013348:Subclavian Artery / Q000601:surgery*