Intratracheal Insufflation of Gas Combined with Conventional and Non-conventional Artifi-cial Pulmonary Ventilation -New Possibilities of Assisted Ventilation

Overview

Intratracheal gas insufflation (TGI)is considered an effective supplement of artificial pulmonary ventilation(UPV)reducing the PaCO2 level along with reduction of its pressure and volume effects by reducing the ventilationvolume (VT).The principle of the effect of TGI is reduction of the ventilation dead space (VD)by rinsing it withfresh gas brought in to the level of the carina.Due to reduction of VD the ratio VT/VD changes and thus also theconditions for alveolar ventilation (VA)change.It is obvious that during non-conventional ventilation regimes suchas in particular high frequency oscillation ventilation (HFOV)when VT is close to VD the change of their ratio willplay an important role during the blood gas exchange.Authors ’investigation was made with the objective tocompare the effect of a combination of TGI with conventional UPV (CV)and with HFOV on blood gas exchange,pressure and volume parameters of ventilation and to assess the optimal TGI flow (QTGI)to achieve an effect onPaCO2,PaO2 and VT ensuing from reduction of VD.For investigation of each method and their comparison twogroups of nine healthy rabbits were used (weight 1.8 -3.2 kg),with air ventilation (FiO2 =0.21).For CV and HFOVvolume controlled ventilation was selected. Measurements and main results:A statistically significant drop of PaCO2 (-3.9 ±0.9 Torr),increase of PaO2(8.2 ±3.6 Torr)and decline of VTCELK (-12 ±3.1 %)during combination CV+TGI is apparent already during a flowof QTGI =0.5 l/min (for all variables p

Key words:
artificial pulmonary ventilation,tracheal gas insufflation,high frequency oscillatory ventilation