Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Open Forum
    • 2023 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Open Forum
    • 2023 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleOriginal Contributions

Setting Positive End-Expiratory Pressure During Jet Ventilation to Replicate the Mean Airway Pressure of Oscillatory Ventilation

Andora L Bass, Michael A Gentile, John P Heinz, Damian M Craig, Donna S Hamel and Ira M Cheifetz
Respiratory Care January 2007, 52 (1) 50-55;
Andora L Bass
Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
Department of Pediatric Critical Care, East Carolina University, Brody School of Medicine, Greenville, North Carolina.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
Michael A Gentile
Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
RRT FAARC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John P Heinz
Department of Neonatology, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
RRT
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Damian M Craig
Department of Cardiothoracic Surgery, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
MSc
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Donna S Hamel
Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
RRT FAARC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ira M Cheifetz
Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina
MD FAARC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
Loading

Abstract

BACKGROUND: High-frequency ventilation can be delivered with either oscillatory ventilation (HFOV) or jet ventilation (HFJV). Traditional clinician biases may limit the range of function of these important ventilation modes. We hypothesized that (1) the jet ventilator can be an accurate monitor of mean airway pressure (P̄aw) during HFOV, and (2) a mathematical relationship can be used to determine the positive end-expiratory pressure (PEEP) setting required for HFJV to reproduce the P̄aw of HFOV.

METHODS: In phase 1 of our experiment, we used a differential pressure pneumotachometer and a jet adapter in-line between an oscillator circuit and a pediatric lung model to measure P̄aw, PEEP, and peak inspiratory pressure (PIP). Thirty-six HFOV setting combinations were studied, in random order. We analyzed the correlation between the pneumotachometer and HFJV measurements. In phase 2 we used the jet as the monitoring device during each of the same 36 combinations of HFOV settings, and recorded P̄aw, PIP, and ΔP. Then, for each combination of settings, the jet ventilator was placed in-line with a conventional ventilator and was set at the same rate and PIP as was monitored during HFOV. To determine the appropriate PEEP setting, we calculated the P̄aw contributed by the PIP, respiratory rate, and inspiratory time set for HFJV, and subtracted this from the goal P̄aw. This value was the PEEP predicted for HFJV to match the HFOV P̄aw.

RESULTS: The correlation coefficient between the pneumotachometer and HFJV measurements was r = 0.99 (mean difference 0.62 ± 0.30 cm H2O, p < 0.001). The predicted and actual PEEP required were highly correlated (r = 0.99, p < 0.001). The mean difference in these values is not statistically significantly different from zero (mean difference 0.25 ± 1.02 cm H2O, p > 0.15).

CONCLUSIONS: HFJV is an accurate monitor during HFOV. These measurements can be used to calculate the predicted PEEP necessary to match P̄aw on the 2 ventilators. Replicating the P̄aw with adequate PEEP on HFJV may help simplify transitioning between ventilators when clinically indicated.

  • high-frequency ventilation
  • jet ventilation
  • oscillatory ventilation
  • mechanical ventilation
  • positive end-expiratory pressure
  • mean airway pressure
  • oxygenation
  • acute lung injury
  • acute respiratory distress syndrome
  • neonate
  • pediatric

Footnotes

  • Department of Pediatric Critical Care Medicine, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, Department of Pediatric Critical Care, East Carolina University, Brody School of Medicine, 600 Moye Boulevard, Greenville NC 27834. Email: bassa{at}ecu.edu.
  • Andora L Bass MD presented a version of this report at the 22nd Conference on High-Frequency Ventilation of Infants, Children, and Adults, held April 6–9, 2005, in Snowbird, Utah.

  • Copyright © 2007 by Daedalus Enterprises Inc.
PreviousNext
Back to top

In this issue

Respiratory Care: 52 (1)
Respiratory Care
Vol. 52, Issue 1
1 Jan 2007
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Setting Positive End-Expiratory Pressure During Jet Ventilation to Replicate the Mean Airway Pressure of Oscillatory Ventilation
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Setting Positive End-Expiratory Pressure During Jet Ventilation to Replicate the Mean Airway Pressure of Oscillatory Ventilation
Andora L Bass, Michael A Gentile, John P Heinz, Damian M Craig, Donna S Hamel, Ira M Cheifetz
Respiratory Care Jan 2007, 52 (1) 50-55;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Setting Positive End-Expiratory Pressure During Jet Ventilation to Replicate the Mean Airway Pressure of Oscillatory Ventilation
Andora L Bass, Michael A Gentile, John P Heinz, Damian M Craig, Donna S Hamel, Ira M Cheifetz
Respiratory Care Jan 2007, 52 (1) 50-55;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • high-frequency ventilation
  • jet ventilation
  • oscillatory ventilation
  • mechanical ventilation
  • positive end-expiratory pressure
  • mean airway pressure
  • oxygenation
  • acute lung injury
  • acute respiratory distress syndrome
  • neonate
  • pediatric

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire