Gas trapping with high-frequency ventilation: jet versus oscillatory ventilation.

Gas trapping was evaluated during high-frequency jet ventilation (HFJV) and high-frequency oscillatory ventilation (HFOV) in nine adult rabbits under basal conditions and after instillation of a mixture of 20% human meconium (2 mL/kg). The anesthetized animals underwent tracheostomy and were placed inside a body plethysmograph. Respiratory compliance and resistance were calculated from airway pressure and simultaneous flow, and volume was measured with a pneumotachograph. Gas trapping was measured as the change in volume observed in the plethysmograph after clamping the jet or the oscillatory line at respiratory rates of 10 and 15 Hz and tidal volumes of 1.0 and 2.0 mL/kg. Mean airway pressure was similar with both ventilators. Inspiratory/expiratory ratios were 1:4 at 10 Hz and 1:2 at 15 Hz with HFJV, and 1:1 during HFOV. Under all conditions, gas trapping was significantly greater with HFJV than with HFOV. More gas trapping was observed with higher tidal volume (2 mL/kg) and respiratory rate (15 Hz) during HFJV, before and after meconium instillation. After meconium instillation, gas trapping during HFJV at 15 Hz and tidal volume 2 mL/kg decreased significantly (32.7 +/- 10.4 to 24.9 +/- 10.3; P less than 0.05), compared with basal conditions. This finding may be explained by the shorter time constant of the respiratory system after meconium instillation (0.118 vs 0.083 seconds, P less than 0.01). Thus gas trapping was significantly greater with HFJV than with HFOV, a difference most likely related to the active expiratory phase of HFOV.

Duke Scholars

Author Ronald Norman Goldberg Pediatrics, Neonatology