[The efficacy of HFJV (high frequency jet ventilation) for ARDS (adult respiratory distress syndrome) following total arch replacement].
A 40-year-old man was admitted to the hospital with shock due to acute aortic dissection (type A of Stanford classification). The emergent total arch replacement was performed with the retrograde cerebral perfusion uneventfully. At the 3rd day after the operation, bilateral infiltrates were recognized on the frontal chest radiograph. The oxygenation was gradually decreased to less than 200 mmHg of PaO2/FiO2 in proportion with the growth of infiltrates and increase of LDH in blood. Steroid therapy was not effective. So then HFJV was introduced to improvement of hypoxygenation at the 16th day after the operation. HFJV made PaO2/FiO2 improve immediately to more than 300 mmHg and the inspiratrory pressure decrease to less than 30 mmHg. Bilateral infiltrates were diminished by HFJV. LDH in blood decreased apparently. HFJV had been used together during 15 days. The respirator was weaned at the 46th day after the operation. In this clinical course, the change of PaO2/FiO2 had the negative correlation with that of LDH in blood.
Nakano
I L
IL
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan.
Siikawa
A
A
Uchikawa
S
S
Okayama
M
M
D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D006611:High-Frequency Jet Ventilation; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*