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Lung pathology after high frequency jet ventilation combined with low rate intermittent mandatory ventilation in a canine model of meconium aspiration
Author(s) -
Keszler Martin,
Klappenbach R. Scott,
Reardon Eileen
Publication year - 1988
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950040305
Subject(s) - medicine , mean airway pressure , ventilation (architecture) , meconium aspiration syndrome , anesthesia , lung , peak inspiratory pressure , high frequency ventilation , meconium , airway , mechanical ventilation , respiratory system , tidal volume , fetus , pregnancy , mechanical engineering , biology , engineering , genetics
The microscopic appearance of lungs subjected to six hours of conventional ventilation (CV), standard high frequency jet ventilation (HFJV), and HFJV combined with low rate intermittent mandatory ventilation (CHFJV) was studied in 22 mongrel puppies. A lung injury model was created by insufflating 4 ml/kg of a 20% mixture of meconium into the trachea. The animals were initially ventilated at the same mean airway pressure (Paw). Subsequently, if P co2 fell below 20 torr, peak and mean airway pressures were reduced. A scoring system was devised which assigned 0–3 points for each of eight lung injury parameters, and a total lung injury score (TLIS) was calculated. CHFJV resulted in significantly less bronchopneumonia and edema, when compared to CV. A consistent, though not significant, trend toward lesser injury scores in CHFJV animals was noted for several other parameters. Six of eight lungs exposed to CV had TLIS > 5 compared to only 1 of 9 ventilated by CHFJV. ( P = 0.02). It is concluded that CHFJV may have a protective effect on the lung, perhaps because effective gas exchange is achieved with a lower pressure amplitude and at lower Paw.