Общая реаниматология (Dec 2010)

Non-Invasive Airway Cleansing with Application of Expulsion Effect of HFJV (High Frequency Jet Ventilation)

  • A. Hermely,
  • M. Jakubova,
  • J Salantay,
  • P. Candik,
  • I. Sopko,
  • M. Majek,
  • J. Cocherova,
  • P. Torok

DOI
https://doi.org/10.15360/1813-9779-2010-6-71
Journal volume & issue
Vol. 6, no. 6

Abstract

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The aim of this study was to demonstrate the effectiveness of the use of expulsion and impulsion nozzle high frequency ventilation (VFDV) for cleansing respiratory system during long-term mechanical ventilation. Material and methods. Retrospective study. In the group of 198 patients presenting its own procedures and the application of inpulsive and expulsive effect of the nozzle frequency ventilation (VFDV) for cleansing and maintaining a patent airway. They used high frequency jet ventilation with the possibility of expulsion and epulsion programming and assessed a total of over 8000 expulsion procedures. Changes in lung mechanics, hemodynamics, effectiveness of expulsion and the need for suction beforeexpulsion and in regular application of VFDV were monitored. Results. We statistically compared and evaluated the effectiveness of expulsion in the VFDV group of 198 patients on long-term UVP, which was effective in average of 94.9% of patients. The impact of expulsion regime on circulatory, ventilation systems and gas exchange in the lungs, including lung mechanics, were analyzed. The authors found that the application of VFDV had a substantial and statistically significant effect on hemodynamics. Application of expulsion and lavage (a technique is described) statistically significantly reduced airway resistance Raw (p<0.01) and improved the levels of lung static compliance (p<0.01) compared with the prior expulsion. Changes in blood gases during the expulsion itself did not have a major impact on gas exchange in the lungs or on the pH in this group, but there was a statistically significant increase in PaO2 (p<0.05). A key finding was that when comparing the number of manipulations in the airways (suction), a radical reduction in the number of pumping was observed, if expulsion was used regularly. A statistically significant difference in the application of expulsion was detected when compared to most groups of patients (p<0.01). The number of necessary manipulations on the airways was reduced by over 100%. Reducing the number of suctions decreased traumatization of mucosa and the risk of infectious complications. Conclusion. The expulsion and lung lavage was an effective and noninvasive method for airway cleansing. VFDV expulsion could contribute to substantial improvements in the care of the maintenance of airway patency in long-UVP. Keywords: respiratory cleansing, long-term UVP, high frequency ventilation, expulsion, inpulsion.