Schragl E, Donner A, Kashanipour A, Aloy A
Klinik für Anästhesie und Allgemeine Intensivmedizin der Universität Wien.
Anaesthesist. 1995 Jun;44(6):429-35. doi: 10.1007/s001010050172.
The study aimed to evaluate whether superimposed high-frequency jet ventilation (SHFJV) is a useful tool in intensive care medicine to ventilate patients with pulmonary insufficiency. METHODS. SHFJV is the simultaneous application of low- and high-frequency jet ventilation performed using a specially designed ventilator. SHFJV versus conventional mechanical ventilation (CMV) was were applied in three groups of patients. Group 1 (Gr 1) included patients without pulmonary insufficiency; group 2 (Gr 2) patients had moderate and those in group 3 (Gr 3) had severe pulmonary insufficiency. RESULTS. In Gr 1 and Gr 2, SHFJV was associated 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 paO2 140.1 vs. 109.9 mm Hg, P < 0.05; mean FiO2 0.66 vs. 0.86, P < 0.05). Other parameters, such as maximum airway pressure (Pmax) and mean Paw, were significantly lower with SHFJV than CMV (mean Pmax 29.6 vs. 40.1 mm Hg, mean Paw 18 vs. 21.9 mm Hg, P < 0.05). Intrapulmonary shunt fractions showed a significant decrease with SHFJV (24.6 vs. 34.4, P < 0.05). CONCLUSIONS. Significant differences were observed primarily in Gr 3 patients, indicating that patients with severe pulmonary insufficiency may benefit from SHFJV. SHFJV may thus represent an alternative mode of ventilation in critically ill patients.
该研究旨在评估叠加高频喷射通气（SHFJV）是否是重症医学中用于为肺功能不全患者进行通气的一种有用工具。方法：SHFJV是使用专门设计的呼吸机同时应用低频和高频喷射通气。将SHFJV与传统机械通气（CMV）应用于三组患者。第1组（Gr 1）包括无肺功能不全的患者；第2组（Gr 2）患者有中度肺功能不全，第3组（Gr 3）患者有重度肺功能不全。结果：在Gr 1和Gr 2中，SHFJV与平均气道压显著降低相关（平均气道压12.9 vs. 13.3 mmHg，P<0.05）。在Gr 3中，SHFJV的氧合明显更好（平均动脉血氧分压140.1 vs. 109.9 mmHg，P<0.05；平均吸入氧浓度0.66 vs. 0.86，P<0.05）。其他参数，如最大气道压（Pmax）和平均气道压，SHFJV明显低于CMV（平均Pmax 29.6 vs. 40.1 mmHg，平均气道压18 vs. 21.9 mmHg，P<0.05）。肺内分流分数SHFJV时显著降低（24.6 vs. 34.4，P<0.05）。结论：主要在Gr 3患者中观察到显著差异，表明重度肺功能不全患者可能从SHFJV中获益。因此，SHFJV可能代表危重症患者的一种替代通气模式。
