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Intrapulmonary Drug Administration during High Frequency Jet Ventilation

Published online by Cambridge University Press:  28 June 2012

M. Klain
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
H. Keszler
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
U. Nordin
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
R. Kalla
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.

Extract

It has previously been demonstrated that high frequency jet ventilation, via transtracheal cricothyroid membrane puncture, can maintain good gas exchange even during cardiopulmonary resuscitation. When the upper airways were filled with fluid, aspiration could be prevented without a cuffed endotracheal tube when respiratory rates of 100/min or higher and an inspiratory time of at least 50% were used. We have also shown that cricothyroid membrane puncture is relatively easy to perform and produces less tracheal damage than a cuffed endotracheal tube.

In one of our studies, cardio-green dye was mixed into the jet using a Y-connector on the proximal end of the angiocath cannula (Figure 1). In two dogs, the distribution of the dye in the lungs was investigated. It was found that nebulized dye was transported by the jet stream to the most distant bronchi which could be observed. On subsequent autopsy, the dye was found in the most peripheral airways.

Type
Part II: Clinical Care Topics
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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