PRELIMINARY EXPERIENCE WITH SUPERIMPOSED HIGH-FREQUENCY JET VENTILATION (SHFJV) IN CRITICALLY ILL PATIENTS

The study aimed to evaluate whether superimposed high-frequency jet ve ntilation (SHFJV) is a useful tool in intensive care medicine to venti late patients with pulmonary insufficiency. Methods. SHFJV is the simu ltaneous application of low- and high-frequency jet ventilation perfor med using a specially designed ventilator. SHFJV versus conventional m echanical ventilation (CMV) was were applied in three groups of patien ts. Group 1 (Gr 1) included patients without pulmonary insufficiency; group 2 (Gr 2) patients had moderate and those in group 3 (Or 3) had s evere pulmonary insufficiency. Results. In Gr 1 and Gr2, SKFJV was ass ociated with a significant decrease in mean airway pressure (mPAW 12.9 vs. 13.3 mm Hg, P<0.05). In Gr 3 oxygenation was significantly better with SHFJV (mean paO(2) 140.1 vs. 109.9 mm Hg, P<0.05; mean FiO(2) 0. 66 vs. 0.86, P<0.05). Other parameters, such as maximum airway pressur e (Pmax) and mean Paw, were significantly lower with SHFJV than CMV (m ean Pmax 29.6 vs. 40.1 mm Hg, mean Paw 18 vs. 21.9 mm Hg, P<0.05). Int rapulmonary shunt fractions showed a significant decrease with SHFJV ( 24.6 vs. 34.4, P<0.05). Conclusions. Significant differences were obse rved primarily in Gr 3 patients, indicating that patients with severe pulmonary insufficiency may benefit from SHFJV. SHFJV may thus represe nt an alternative mode of ventilation in critically ill patients.