The Efficiency of CO2 Elimination During High-Frequency Jet Ventilation for Laryngeal Microsurgery
| Autor: | Roman Rohling, Peter Biro, Gerold Eyrich |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Artificial ventilation Percentile Partial Pressure medicine.medical_treatment law.invention High-Frequency Jet Ventilation High frequency jet ventilation law medicine Humans Aged Retrospective Studies Laryngeal microsurgery business.industry High-frequency ventilation Carbon Dioxide Middle Aged medicine.disease Obstructive lung disease Oxygen Anesthesiology and Pain Medicine Anesthesia Ventilation (architecture) Larynx business Airway |
| Zdroj: | Anesthesia & Analgesia. 87:180-184 |
| ISSN: | 0003-2999 |
| DOI: | 10.1097/00000539-199807000-00037 |
| Popis: | For adequate and safe use of high-frequency jet ventilation (HFJV), reliable monitoring of the Pco 2 status and course is necessary. Because of improved handling and performance, recently available transcutaneous Pco 2 monitoring devices such as MicroGas7650 (Kontron Instruments Medical Sensors, Basel, Switzerland) should enable more effective surveillance of CO 2 elimination and, subsequently, better control of subglottic HFJV. Adult patients(n = 164) undergoing laryngeal microsurgery during total IV anesthesia were assessed. The resulting transcutaneous Pco 2 values, as well as the necessary driving pressure settings, were analyzed to define the CO 2 elimination capacity of each patient. Therefore, an individual CO 2 elimination coefficient (ECCO 2 ) was calculated. The frequency distribution of the obtained ECCO 2 values showed a normal distribution with a median at 0.79 and a range between 0.30 and 2.17. A significant difference in the frequency of obstructive lung disease was found between two patient subpopulations separated by the 25th percentile at an ECCO 2 value of 0.63. Other co-factors of CO 2 elimination during HFJV were age, gender, and body weight, whereas height and ventilation duration were not involved. We conclude that the individual assessment of ECCO 2 enables one to find adequate ventilator settings, resulting in lower airway pressure and less cooling and drying of the tracheobronchial mucosa. Implications: CO 2 elimination during high-frequency jet ventilation can be assessed by calculating the CO 2 elimination coefficient (ECCO 2 ) of each patient from the required driving pressure and the resulting transcutaneous CO 2 partial pressure. The frequency distribution of ECCO 2 in a typical laryngological patient population was analyzed, and a value of 0.63 was found to be a characteristic limit between sufficient and difficult CO 2 elimination. The individual assessment of ECCO 2 enables one to find adequate ventilator settings, resulting in lower airway pressure and less cooling and drying of the tracheobronchial mucosa. |
| Databáze: | OpenAIRE |
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