Anestéziológia a intenzívna medicína 1/2012
Non-invasive airway toilet using expulsion effect of HFJV (high frequency jet ventilation)
Background: The authors describe the practices that help maintain airway patency during long-term mechanical ventilation. The aim of this study was to demonstrate the effectiveness of the use of expulsion and inpulsion nozzle high frequency ventilation (HFJV) for airway toilet of respiratory system during long-term mechanical ventilation. Design: Retrospective study. Material and methods: In the group of 241 patients presenting its own procedures and the application of inpulsion and expulsion effect of high frequency jet ventilation (HFJV) 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´s procedures. Monitor changes in lung mechanics, hemodynamics, effectiveness of expulsion and the need for manipulation of the suction catheter in the airway before using expulsion and in regular application of HFJV. Results: Statistically compare and evaluate the effectiveness of expulsion in the HFJV group of 241 patients on long-term ALV, which was effective on average for 86,7% of patients. Compare the impact of expulsion´s regime on circulatory system, ventilation system and gas exchange in the lungs, including lungs mechanics. The authors found that the application of HFJV has a substantial and statistically significant effect on haemodynamics. Application of expulsion and lavage, (a technique is described), statistically significantly reduces airway resistance Raw (p <0.01) and has an impact on improving the levels of lungs Cst static compliance (p <0.01) compared with the prior expulsion. Changes in blood gases during the expulsion itself don´t have a major impact on gas exchange in the lungs or the pH in this group, but there was a statistically significant increase in PaO2 (p <0.05). A key finding is that when comparing the number of manipulations in the airways (suction) was in all cases to a radical reduction in the number of pumping if expulsion was used at regular intervals. A statistically significant difference in the application of expulsion is when compared to most groups of patients at level (p <0.01). The number of necessary manipulations in the airways was reduced by over 100%. Reducing the number of suction catheter´s manipulations in airway reduces traumatization of mucosa and the risk of infectious complications. Conclusion: In conclusion, thez note that the expulsion and lung lavage is an effective and noninvasive method for airway toilet. HFJV expulsion may contribute to substantial improvements in the care of the maintenance of airway patency in long-ALV (artifitial lung ventilation).
Keywords: respiratory toilet, long-term AKV, high frequency jet ventilation, expulsion, inpulsion.
