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Biomedical subjects

M Klain

Publications and source records attributed to M Klain.

At least 55 records · Page 3Linked to original sources
PubMed1982

Comparison of venous admixture during high-frequency ventilation and conventional ventilation in oleic acid-induced pulmonary edema in dogs.

High-frequency jet ventilation (HFJV) was compared with conventional ventilation ventilation during oleic acid-induced pulmonary edema in dogs. HFJV, when combined with positive end-expiratory pressure (PEEP), returned arterial PO2 (PAO2) and venous admixture to preoleic acid levels, even with tidal volumes as low as 4.8 ml/kg and rates of 300 min-1. When HFJV was compared with conventional (low-frequency, high tidal volume) ventilation at the same Flo2 and level of PEEP, Pao2 was lower and venous admixture higher with HFJV. However, venous admixture was lower with HFJV when comparisons were made at the same peak airway pressure, because of a higher level of PEEP compared with conventional ventilation. At each level of PEEP, cardiac and stroke indices were not different between the two methods of ventilation. The ability to eliminate CO2 with lower peak airway pressures or to increase PEEP without further increases in peak airway pressure are the primary advantages of HFJV during severe lung injury. Oxygenation is as efficient during HFJV as during conventional ventilation in this model of pulmonary edema when comparisons are made at the same peak airway pressure, but less efficient at the same PEEP.

Airway Resistance↗
PubMed1981

High-frequency jet ventilation during the treatment of acute fulminant pulmonary edema.

High-frequency jet ventilation (HFJV) was used during the treatment of fulminant pulmonary edema in a 45-year-old man so that toxic levels of oxygen could be avoided when conventional methods of ventilation in combination with high levels of PEEP (20 cm H2O) were unsuccessful in raising PaO2. On each of four occasions, HFJV resulted in improved arterial oxygenation when compared with conventional modes.

Acute Disease↗
PubMed1980

Limits of high frequency percutaneous transtracheal jet ventilation using a fluidic logic controlled ventilator.

A study was undertaken on dogs to find the limit of carbon dioxide exchange with high frequency jet ventilation using a fluidic logic controlled oxygen jet ventilator. Fifteen dogs were ventilated through a transtracheal catheter at respiratory rates up to 600 per minute. The following were recorded: aortic, pulmonary artery, pulmonary arterial wedge, and central venous blood pressures; intratracheal pressure, electrocardiogram; inspiratory and expiratory time of the jet; arterial and central venous blood gases; intermittent cardiac output. Normal gas exchange was found up to a respiratory rate of 400 per minute with low tidal volume and low intratracheal pressures. There were no adverse circulatory effects up to a rate of 400 per minute. At rates of 500 and 600 per minute, cardiac contractility was unaffected, but a decreased heart rate and increased peripheral resistance produced a fall in cardiac output. There was no interference with the resumption of spontaneous ventilation during weaning. In a control series of five dogs, apnoeic oxygenation was used. The PaCO2 was allowed to reach 15.96 kPa (120 torr). High frequency jet ventilation was then started at a rate of 600 per minute and decreased in increments to 100 per minute. Arterial blood gases were continuously recorded through an intra-arterial catheter connected to a mass spectrometer. The PaCO2 gradually declined to normal levels as the rate decreased.

Animals↗
PubMed1980

Tracheobronchial toilet without cardiorespiratory impairment.

Suctioning of the tracheobronchial tree during high frequency jet ventilation (HFJV) in two groups of apneic dogs could be prolonged to 2 min without producing significant drops in PaO2, slowing of the pulse or marked hypertension. Arrhythmias were also virtually absent. The controls reacted to suctioning like human patients. A sharp drop in PaO2, an increase in PaCO2 and a change in pulse rate and blood pressure (BP) as well as frequent premature ventricular contractions were observed.

Animals↗
PubMed1976

Percutaneous transtracheal ventilation.

The technique of percutaneous transtracheal ventilation (intermittent jets of oxygen under high pressure, 50 pounds per square inch [psi]) has been used for resuscitation during anesthesia and prior to tracheostomy, and has been established as an important adjunct to life-support techniques. The technical aspects are described together with experimental evidence that intermittent jet ventilation is necessary to eliminate carbon dioxide. The complications occurring with a series of 80 patients are reported along with experimental work in ventilation of dogs with compressed air sources, including truck tires. Emergency physicians should be familiar with this technique and equipment for its use should be readily available in the emergency department. The potential role of transtracheal ventilation in the mobile intensive care unit at accident sites has been explored and appears promising. Conventional airway support techniques should be applied prior to resorting to transtracheal ventilation.

Adolescent↗
PubMed1976

Jet ventilation for fiberoptic bronchoscopy under general anesthesia.

An oxygen jet method ventilating patients during laryngoscopy has been applied to fiberoptic bronchoscopy. A 3.5 mm plastic tube 24.5 cm long was inserted into the trachea through the mouth. An intermittent jet of oxygen at 3.5 atm (50 psi) was applied to this tube using a 1.5 mm ID plastic catheter to ventilate the patient. Anesthesia was accomplished with intravenous thiamylal and Innovar. The patients were paralyzed with continuous succinylcholine. The technique has subsequently been used without complications in more than 1,000 patients. A fluidic ventilator was developed for delivering and controlling the oxygen jet. The airway pressure can be monitored continuously and, by the use of fluidic devices, the jet can be set to cut off automatically if the airway pressure is too high. The above techique for laryngoscopy with the fluidic ventilator was used in 28 patients undergoing fiberoptic bronchoscopy (Olympus 5.7 mm diameter). The airway pressure was continuously monitored with a line attached to the suction port of the bronchoscope. Arterial PCO2 ranged from 23 to 42 mmHg and PO2 from 105 to 325 mmHg. The high PO2 levels were maintained even during suctioning. General anesthesia for fiberoptic bronchoscopy can be performed using an endotracheal tube not smaller than 8 mm internal diameter (ID). The advantages of the oxygen jet technique are that it can be used in smaller patients and that the upper airway can be examined.

Anesthesia, General↗