Humidification and airway pressures during high-frequency jet ventilation delivered through the suction-biopsy channel of a flexible bronchofiberscope.

The suction-biopsy channel (SBC) of a flexible bronchofiberscope was used to deliver gas into the trachea during high-frequency jet ventilation (HFJV) at a rate of 95 cycle/min and a tidal volume (VT) of 95 ml. A Portex epidural catheter inserted into the SBC was used to entrain water for humidification by the injector principle. Inspired humidity (IH) was regulated by adjusting the distance (D) between the injector and jet portals. Airway pressures, pulmonary gas exchange and IH levels were measured in 11 dogs. In addition, tracheal cytology scores (TCS, a sensitive index of tracheal epithelial damage caused by breathing dry gases) were assessed in 12 patients. The system maintained adequate pulmonary gas exchange in both dogs and humans. In dogs the mean tracheal pressure was 2.8 +/- 0.5 (SD) torr with a peak pressure of 3.8 +/- 0.5 torr. The upper-airway pressure was subatmospheric (-2 +/- 0.2 torr) during the first half of jet inspiration, but peaked synchronously with tracheal pressures during the second half. Both the upper airway and the trachea had a positive end-expiratory pressure (PEEP) of 1.8 +/- 0.2 torr. When D was 0.3 cm, the system delivered gas with an IH of 44 mg H2O/L (almost saturated at 37 degrees C). Human TCS did not change significantly after 2 h of humidified HFJV, suggesting efficient humidification.