[High frequency jet ventilation in patients with acute respiratory failure. A comparison with conventional artificial respiration].

The major advantage of High Frequency Jet Ventilation (HFJV) in the treatment of patients with ARDS was commonly seen in better oxygenation and lower airway pressures, compared to conventional ventilation. Furthermore, HFJV seemed to be successful even in those patients in whom conventional ventilation had failed. We compared HFJV (f = 100/min, inspiratory time 40% to 50%) to conventional ventilation (f = 10/min, PEEP 5 to 10 cm H2O). For mean airway pressure and FIO2 equal values were chosen in both ventilatory modes. With HFJV paO2 was significantly (P less than 0.01) lower (82.2 +/- 28.2 mmHg compared to 139.2 +/- 23.5 mmHg), intrapulmonary shunting higher (29.2 +/- 19.6% compared to 15.3 +/- 6.4%) than with CV. Ventilatory volume required for normocarbia under HFJV was 25.6 +/- 5.4 l/min approximately equal to 341 +/- 81.8 ml/kg B.W. Pulmonary artery pressure (PAP 25.0 +/- 5.0 mmHg compared to 19.9 +/- 4.7 mmHg), central venous pressure (10.5 +/- 4.2 mmHg compared to 8.8 +/- 3.0 mmHg), pulmonary capillary pressure (13.3 +/- 4.4 mmHg compared to 11.3 +/- 3.7 mmHg), pulmonary vascular resistance (131.4 +/- 55.0 dyn . s . cm-5 compared to 96.7 +/- 33.7 dyn . s . cm-5) and right cardiac work index (1.38 +/- 0.55 kg . m/m2 compared to 1.05 +/- 0.33 kg . m/m2) were significantly increased (P less than 0.01) under HFJV. The other haemodynamic variables showed no difference between the two ventilatory modes. HFJV was inferior to conventional artificial ventilation in all patients and caused severe hypoxia in several patients, leading to pulmonary vasoconstriction and increased work of the right heart.(ABSTRACT TRUNCATED AT 250 WORDS)