RT Journal Article
SR Electronic
T1 Heliox Administration During High-Frequency Jet Ventilation Augments Carbon Dioxide Clearance
JF Respiratory Care
FD American Association for Respiratory Care
SP 1038
OP 1044
VO 49
IS 9
A1 Vineet K Gupta
A1 Eva N Grayck
A1 Ira M Cheifetz
YR 2004
UL http://rc.rcjournal.com/content/49/9/1038.abstract
AB We report the combined use of heliox and high-frequency jet ventilation to augment carbon dioxide clearance, with a focus on the important technical considerations. Our case is a 5-month old infant with acute respiratory failure associated with gas trapping, hypercarbia, respiratory acidosis, and air leak. Despite maximal conventional ventilation, bronchodilator therapy, corticosteroids, and sedation, the infant continued to demonstrate worsening gas exchange necessitating an escalation of support to high-frequency oscillatory ventilation. After the development of an air leak and continued difficulties with carbon dioxide clearance, the patient was transitioned to high-frequency jet ventilation. Persistent hypercarbia resulted in the addition of heliox to facilitate ventilation. Improvements in gas exchange occurred rapidly. The combination of heliox and high frequency jet ventilation resulted in improved carbon dioxide clearance, respiratory stabilization, and the ability to wean ventilator settings.