Volume 2 Supplement 1

18th International Symposium on Intensive Care and Emergency Medicine

Open Access

Nitric oxide application during superimposed high-frequency jet-ventilation in patients with ARDS

  • A Kepka1,
  • C Schabernig1,
  • G Ihra1,
  • P Kraincuk1 and
  • A Aloy1
Critical Care19982(Suppl 1):P113

https://doi.org/10.1186/cc242

Published: 1 March 1998

Introduction

Inhaled nitric oxide (NO) reduces pulmonary hypertension in severe ARDS and improves arterial oxygenation by redistributing blood flow to areas with a normal ventilation/perfusion ratio [1]. As high peak inspiratory pressure (PIP) may contribute to pulmonary damage ventilatory strategies like high-frequency (HF) ventilation search to minimize PIP. This study was designed to evaluate the combined benefits of superimposed high-frequency jet-ventilation (SHFJV), a new HF jet-ventilation technique, with addition of inhalational NO.

Methods

10 patients with severe ARDS were evaluated. All patients where ventilated with a conventional respirator (Evita, Dräger, Germany). The indication for SHFJV was a Horrowitz Index below 100. An electronic prototype jet-ventilator (Alexander 1, Reiner, Austria) used for SHFJV provided simultaneous low-(14-20/min) and high-frequency (400-600/min) jet-streams, which were applied with a special jet-adapter. For application of NO we used the Pulmonox mini (Messer Griesheim, Austria) including a specially developed computer software for precise addition of NO (10 ppm) to the HF jet-stream during inspiration [2]. After 3 h of jet-ventilation we additionally applied NO.

Results

PaO2/FiO2 and Horowitz index increased during SHFJV and NO application, while PIP could be reduced maintaining the same levels of CO2 (Table 1).

Conclusion

The beneficial effect of SHFJV on oxygenation can be combined with the selective effects of inhaled NO. Thereby, impaired pulmonary function can be further improved.

Table 1

 

CPPV

SHFJV

SHFJV and NO

Oxygenation

19.7

16.8

13.9

Horrowitz

96

118

149

PIP (cmH2O)

34

30

30

Authors’ Affiliations

(1)
Department of Anesthesiology and Intensive Care Medicine, University of Vienna, AKH

References

  1. Rossaint R: . Eur J Anaesthesiol. 1994, 11: 43-PubMedGoogle Scholar
  2. SchragI E: . Anaesthetist. 1995, 44: 843-10.1007/s001010050220.View ArticleGoogle Scholar

Copyright

© Current Science Ltd 1998

Advertisement