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. 2010 Sep;111(3):703-6.
doi: 10.1213/ANE.0b013e3181e9c45c. Epub 2010 Jul 2.

Intrinsic positive end-expiratory pressure at various frequencies of supraglottic jet ventilation in a model of dynamic upper airway obstruction

Gerald C Ihra  1 , Ching-Ju Tsai, Oliver Kimberger
Affiliations

Intrinsic positive end-expiratory pressure at various frequencies of supraglottic jet ventilation in a model of dynamic upper airway obstruction

Gerald C Ihra et al. Anesth Analg. 2010 Sep.

Abstract

Background: Supraglottic jet ventilation (JV(S)) with injectors above airway stenoses may result in inadvertent high lung pressures. We designed this study to investigate intrinsic positive end-expiratory pressure (PEEP(i)) during jet ventilation via a distant injector in a model of dynamic upper airway obstruction.

Methods: Respiratory pressure-time curves were recorded during JV(S) in a tracheal lung model using a pig's trachea and an embolectomy catheter's air-filled balloon to simulate 60 and 80% airway obstruction. JV(S) was performed at various jet frequencies (F(jet) 30 min(-1), 60 min(-1), and 100 min(-1)) and driving pressures (1 bar and 2 bar).

Results: JV(S) was associated with generation of PEEP(i), which depended on driving pressure, the degree of obstruction, and on ventilatory frequency.

Conclusions: In the presence of a dynamic upper airway obstruction, JV(S) via a distant injector may result in PEEP(i), which cannot be detected when airway pressure is measured in front of the obstruction.

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