Suppression of spontaneous breathing during high-frequency jet ventilation. Influence of dynamic changes and static levels of lung stretch

Abstract

Conditions which suppress spontaneous breathing activity during high-frequency jet ventilation (HFJV) were analysed in Yorkshire piglets under pentobarbital anesthesia. The highest PaCO2 at which the animals did not breathe against the ventilator (apnea point) was established during different patterns of ventilation, either by changing the minute volume or by adding CO2 to the inspiratory gas. Arterial oxygen tension was maintained throughout the study above 80 mm Hg. An elevation of ventilatory rate increased the apnea point, suggesting a progressive suppression of spontaneous breathing. This suppression did not depend on the amount of lung stretch during insufflation, because at higher rates lower tidal volumes were used. Suppression also appeared to be independent of insufflatory flow, i.e. the velocity of lung stretch. At higher frequencies end-expiratory airway pressure (PEE) increased and there appeared to be a positive relationship between the apnea point and PEE. In a separate series this positive relationship between the apnea point and PEE was confirmed. A hysteresis effect in this relationship, however, suggests that other than jet frequency, lung volume rather than positive end-expiratory pressure (PEEP) is a major determinant of suppression of spontaneous breathing activity during HFJV.