[High frequency jet ventilation].

Abstract

High frequency jet ventilation (HFJV) is a new ventilation technique which ensures satisfactory gas exchanges with tidal volumes of about 2 ml . kg-1. A gas mixture under high pressure is "chopped up" by an electrically-controlled solenoid valve and delivered to the patient by an injection system. A specific heater-humidifier is required for optimal humidity and warmth of the gas mixture. HFJV creates a positive end-expiratory pressure effect in the alveoles, and the increase of mean intratracheal pressure observed accurately reflects the increase of mean alveolar pressure. Convection by direct alveolar ventilation plays a determinant role in CO2 clearance under HFJV, the other gas transport mechanisms being accessory. In respiratory failure with shock HFJV is better tolerated haemodynamically than conventional ventilation. The main indications of the new technique are ENT surgery, thoracic and tracheal surgery, lithotripsy, broncho-pleural and oesophago-tracheal fistulae and circulatory shock.