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At least 19 recordsLinked to original sources
PubMed1977

Phrenic and vagal nerve activities during spontaneous respiration and positive-pressure ventilation.

Afferent vagal nerve activity from stretch-receptors in the lung and efferent phrenic nerve activity were recorded during spontaneous respiration and during positive-pressure ventilation with three different types of ventilators. During spontaneous respiration the efferent phrenic nerve activity slightly preceded the afferent vagal nerve activity. Volume-controlled ventilation did not alter the phrenic nerve activity when the ventilation was set at a rate equal to that during spontaneous respiration, but afferent vagal volleys increased in duration. At higher frequencies of insufflation spontaneous inspiration was inhibited. An increase in afferent vagal nerve activity and a concomitant slight decrease in efferent phrenic nerve activity were obtained during animal triggered pressure-controlled ventilation. High-frequency positive-pressure ventilation (HFPPV) gave rise to basal, non-grouped activity in vagal afferents, causing inhibition of inspiration. During HFPPV, spontaneous respiration can take place on activation of other afferents to the respiratory centre. Clinical aspects of respirator treatment from a neurophysiological standpoint are discussed.

Afferent Pathways↗
PubMed1977

High-frequency positive-pressure ventilation (HFPPV) in neonates and infants during neuroleptal analgesia and routine plastic surgery, and in postoperative management.

The low pulmonary compliance, the high airway resistance and the "rapid" breathing pattern of neonatal and paediatric patients make it necessary to design special ventilators to match the pulmonary physiology of infants. A ventilator system which also in small children has a negligible compression volume was evaluated in a lung model and during repair of cleft lip and palate in 16 patients under general anaesthesia and in two other infants during other operations. High-frequency positive-pressure ventilation (HFPPV) was given with an insufflation frequency (f) of 60 per min and a relative insufflation time (t%) of 32%. In addition, two neonates treated postoperatively with HFPPV are reported. Despite the "open" character of the ventilator system both intra- and postoperative ventilation were uneventful in all patients. The arterial oxygenation was good in all cases, as judged from clinical signs or blood gas analyses. Postoperative ventilation required conventional clinical observation and intermittent analyses of blood. HFPPV has been shown to depress, or abolish, spontaneous respiration via reflex mechanisms. In all patients in this investigation respiratory movements were absent at normo- or slight hyperventilation during HFPPV.

Adult↗
PubMed1975

High-frequency positive-pressure ventilation (hfppv) during transthoracic resection of tracheal stenosis and during peroperative bronchoscopic examination.

Operation of a patient with intrathoracic tracheal stenosis using a new ventilation technique (HFPPV) is described. The technique permits tracheoscopy during ventilation and operation, thus enabling exact location of the stenosis to be obtained. Further, peroperative tracheoscopic checking of the anastomosis can be carried out. Resection and anastomosis can be performed without interference of a bulky endotracheal tube.

Adult↗
PubMed1977

Clinical evaluation of high-frequency positive-pressure ventilation (HFPPV) in laryngoscoy under general anaesthesia.

A technique for automatic ventilation during laryngoscopy under general anaesthesia was evaluated in a lung model and in 5 patients (3--57 y) submitted for routine laryngoscopy. this technique has been given the name laryngoscopic HFPPV and utilizes an insufflation frequency (f) of 60 per min and a relative insufflation time (t%) of 22%. Ventilation is given via a nasotracheal insufflation catheter. Laryngoscopic HFPPV permits laryngeal surgery with a virtually unobstructed surgical field under complete muscular relaxation. The alveolar ventilation of the patient may be controlled by adjustment of the pressure of the anaesthetic gas mixture and there is no air entrainment through the larynx during insufflation. This makes possible use of O2/N2O mixtures and the oxygenation of the patient may be controlled by adjustment of the oxygen concentration of the anaesthetic gas mixture. As there is a continuous upward has flow through the larynx, blood or pieces of loose tissue are not sucked down into the trachea. A simple ventilation nomogram for clinical use is proposed. Adequately used, this nomogram guarantees safe ventilation during laryngoscopic HFPPV. An Fio2 of 0.3--0.4 gives adequate arterial oxygenation.

Anesthesia, General↗
PubMed1975

Light- and electron microscopic investigations of pulmonary tissue after high-frequency positive-pressure ventilation (HFPPV).

Narcotisized dogs were artificially ventilated for periods of two to five hours with HFPPV. During this time the blood gases, pH and bases were controlled. In spite of sufficient oxygenation and CO2-elimination, a metabolic acidosis developed which could not be fully compensated by the addition of buffer solutions. In light and electron microscopy these lungs did not differ significantly from control lungs. Haemorrhages or atelectases were never observed. Type I cells as well as Type II cells in the alveoli are unchanged, i.e. the Type II cells were not depleted but contained numerous typical lamellar bodies with a diameter of 0.4-1 mu. The blood gas barrier was not widened and was ca. 3000 A wide. The alveolar surface was coated by an often fragmented electron-dense film (monolayer of the surfactant).

Acid-Base Equilibrium↗
PubMed1992

High frequency oscillation.

The current state of high frequency oscillation (HFO) in Japan is reviewed. The discussion is focused on the following: (i) the repeated application of short duration SI (sustained inflation) is effective in recruiting lung volume and increasing PaO2; (ii) HFO can prevent the formation of granulocytes related to lung injury; and (iii) HFO does not increase the risk of severe complications such as air leaks, bronchopulmonary dysplasia or intraventricular hemorrhage.

Animals↗
PubMed1992

Effect of mean airway pressure on bronchial mucosal blood flow in rabbits with oleic acid-induced injury.

The effects of mean airway pressure (MAP) on bronchial mucosal blood flow at the carina in nine anesthetized adult rabbits undergoing high frequency ventilation were studied. The animals were given oleic acid to diminish lung compliance and to exclude the influences of increasing MAP on systemic venous return. Mucosal blood flow decreased significantly when MAP exceeded 14 cmH2O. Mucosal blood velocity tended to decrease as higher levels of MAP were applied. Mucosal blood volume decreased significantly when MAP exceeded 20 cmH2O. Hemodynamics, arterial blood gas values and pH were not changed significantly. Our data demonstrate that bronchial mucosal blood flow decreases at high levels of MAP even if cardiac output remains constant. Hence this decrease of bronchial mucosal blood flow may be due to the transmission of pressure to submucosal bronchial capillaries.

Animals↗
PubMed1976

Renal function in experimental chronic hydronephrosis. V. Net acid excretion capacity in relation to renal pelvic volume after maximal loading with NH4Cl.

In 12 mongrel dogs intravenous loading with ammonium chloride (4 mmol NH4+/kg body weight) was performed before and 2-9 weeks after unilateral hydronephrosis had been produced by ligation of the ureter over an indwelling catheter. In an attempt to satisfy the demand for adequate, constant, alveolar ventilation a special respirator of the high-frequency positive-pressure ventilation (HFPPV) type was used. The acid-base status of the blood was determined before and after the loading and the acidification capacity of each kidney was assessed by measuring the amount of titratable acid and ammonium ions excreted in the urine. In the hydronephrotic kidney the excretion of both titratable acid and ammonium ions was statistically significantly reduced, both compared with the initial values in session I and compared with the healthy kidney in session II. After additional loading with ammonium chloride in session II, however, both kidneys increased their excretions to approximately similar extents. When the excretion was calculated per ml glomerular filtrate, no statistically significant changes were found between sessions I and II, either for the intact or the hydronephrotic kidney. The renal pelvic volume on the hydronephrotic side was measured and related to the reduction of the capacity of the kidney to excrete titratable acid and ammonium ions. No statistically significant correlation was obtained.

Acid-Base Equilibrium↗
PubMed1979

New parachute cuff and positive end-expiratory pressure to minimize tracheal injury and prevent aspiration.

A new parachute cuff has been tested in combination with a positive end-expiratory pressure (PEEP) on mongrel dogs. During positive-pressure ventilation the intracuff and intratracheal pressures showed synchronous, identical pressure variations, and therefore theoretically with this type of cuff the pressure against the tracheal wall would be minimal. The cuff provided a seal against gas leakage from the lungs throughout the entire test period, i.e., for up to 7 h. To avoid aspiration of mouth contents during the passive exhalation phase, different amounts of PEEP were tested. A PEEP of 4.0--8.0 cm H2O always produced a seal against a column of fluid in the mouth exerting a hydrostatic pressure of 5.4--8.8 cm H2O against the cuff. This seal was maintained during the whole test period. No difference in sealing capacity was found when the cuff was used with a normal respiratory frequency (20/min) and with high-frequency positive-pressure ventilation (60/min). When the PEEP is eliminated, e.g., when the respirator is disconnected for suction of the endotracheal tube, the sealing effect will be abolished. As the cuff extends up into the larynx there will be no pooling of fluid above the cuff. The risk of aspiration can therefore be diminished by suction of oral cavity before disconnecting the respirator. With the use of the pneumatic valve principle together with high-frequency positive-pressure ventilation, an open respirator system can produce a continuous PEEP, thereby preventing aspiration even during suctioning of the tracheal tube.

Animals↗
PubMed1977

Physiologic evaluation of the HFPPV pneumatic valve principle and PEEP. An experimental study.

In experiments in dogs the ventilatory and circulatory conditions prevailing with the ventilatory pattern in high-frequency positive-pressure ventilation (HFPPV) were investigated with use of a pneumatic valve principle and a ventilator system of an "open" character. Keeping the gas input constant the importance of insufflation frequency and insufflation time and the reactions to various levels of positive end-expiratory pressure (PEEP) were investigated in terms of changes in arterial pH, Pco2 and Po2. With the volumes of delivered gas kept constant, an increasing insufflation frequency from 60 to 100 per min gave a parallel decrease in tidal volume accompanied by lower maximum intratracheal pressures and a significant decrease in alveolar ventilation. Also taking into account the possibilities of inducing a suppression of the spontaneous respiration, higher ventilatory frequencies than 60 per min do now seem to introduce any further advantages. Including the associated effects on cardiac output and venous admixture, the cardio-pulmonary and circulatory parameters studied did not show any substantial changes with PEEP levels below 7.5--10 cm H2O. Thus the level of PEEP, which often is part of the ventilatory pattern in HFPPV, does not seem to have any untoward influence on the circulation (stroke volume, cardiac output, total peripheral vascular resistance) and oxygen transport (arterial oxygen content and oxygen flux) in normovolaemic dogs.

Animals↗
PubMed1975

Step changes in end-tidal CO2: methods and implications.

A dynamic end-tidal forcing technique for producing step changes in end-tidal CO2 with end-tidal O2 held constant independent of the ventilation response or the mixed venous return is introduced for characterizing the human ventilation response to end-tidal CO2 step changes for both normoxic (PAO2 = 125 Torr) and hypoxic (PAO2 = 60 Torr) conditions. The ventilation response approaches a steady state within 5 min. In normoxia, the on-transient is faster than the off-transient, presumably reflecting the action of cerebral blood flow. The hypoxic step response is faster than the normoxic response presumably reflecting the increased contribution from the carotid body. The delay in the ventilation response after the change in end-tidal CO2 is less in hypoxia than in normoxia and reflects the action of a transport delay and that of a virtual delay. These delays are interpreted with respect to the high-frequency phase shift data for the same subject, generated using sinusoidal end-tidal forcing. The methods of others for experiments utilizing step changes in inspired CO2 are considered with respect to our methods.

Adult↗