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Relationship between driving pressure and tidal volume during high frequency jet ventilation for the tracheal resection

机译：气管切除术高频喷射通气时驱动压力与潮气量的关系

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BACKGROUND: High frequency jet ventilation (HFJV) is a method of ventilation for tracheal resection because it provides a good surgical field and decreases surgical complications. We should know ventilatory settings of HFJV to perform safe respiratory management. In this study we evaluated the relationship between tidal volume (VT) and driving pressure (DP) during HFJV for tracheal resection. METHODS: Twenty patients undergoing tracheal resection under total intravenous anesthesia were studied. Jet pulse was delivered through a 12 or 15 Fr feeding catheter connected to a jet ventilator. We set DP optionally and inspired oxygen concentration 100%, ventilatory frequency 100 x min(-1), and I/T ratio 0.3 or 0.5. In fourteen patients receiving HFJV with 15 Fr catheter we calculated VT by measured PaCO2, reported VCO2 value, and physiological dead space (1.1 x body weight) for each patient and evaluated relationship between VT and DP. RESULTS: HFJV was feasible in all patients. Pneumothrax occurred in one patient. Respiratory complications including pneumonia and respiratory failure were not observed after surgery in all patients. The calculated VT values showed a significant correlation with DP (VT = 48.1 DP + 44.7, r=0.73, P<0.01). CONCLUSIONS: In respiratory management for tracheal resection with HFJV, we can predict DP from VT calculated by expected PaCO2, reported VCO2 value, and physiological dead space. It enables us to perform safe respiratory management.
机译：背景：高频喷射通气（HFJV）是一种气管切除术的通气方法，因为它提供了良好的手术范围并减少了手术并发症。我们应该知道HFJV的通气设置，以进行安全的呼吸管理。在这项研究中，我们评估了在进行气管切除的HFJV期间潮气量（VT）与驱动压力（DP）之间的关系。方法：对20例行全静脉麻醉的气管切除患者进行研究。射流脉冲通过连接到射流呼吸机的12 Fr或15 Fr进料导管传递。我们将DP设置为可选，吸氧浓度为100％，呼吸频率为100 x min（-1），I / T比为0.3或0.5。在14名接受15 Fr导管的HFJV的患者中，我们通过测量PaCO2计算VT，报告VCO2值，以及每位患者的生理死区（1.1 x体重），并评估VT和DP之间的关系。结果：HFJV在所有患者中都是可行的。一名患者发生气胸。所有患者术后均未观察到呼吸系统并发症，包括肺炎和呼吸衰竭。计算出的VT值与DP呈显着相关性（VT = 48.1 DP + 44.7，r = 0.73，P <0.01）。结论：在HFJV气管切除术的呼吸处理中，我们可以根据预期PaCO2，报告的VCO2值和生理死区计算出的VT预测DP。它使我们能够执行安全的呼吸管理。

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