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British Journal of Anaesthesia, 2000, Vol. 84, No. 5 635-637
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communication

Carbon dioxide elimination during high-frequency jet ventilation for rigid bronchoscopy

P. Biro1, M. Layer2, K. Wiedemann2, B. Seifert3 and D. R. Spahn1

1 Institute of Anaesthesiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland
2 Department of Anaesthesiology, Thoraxklinik, Amalienstrasse 5, D-69126 Heidelberg, Germany
3 Department of Biostatistics, University of Zurich, CH-8006 Zurich, Switzerland

P. Biro, Institute of Anaesthesiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland

Oxygen saturation and carbon dioxide values should be monitored during high-frequency jet ventilation (HFJV). Modern transcutaneous P2 (Ptc2) measurement allows the estimation of ventilation efficiency. We studied how tests of lung function could predict carbon dioxide elimination during HFJV. Lung function tests from 180 adult patients undergoing rigid bronchoscopy were analysed as factors affecting carbon dioxide elimination. The lung function test results showed a significant relationship with the efficiency of carbon dioxide elimination; the greatest impairment of carbon dioxide elimination was found in patients with combined abnormalities of lung function. Further factors associated with difficult carbon dioxide elimination were male gender and elevated body weight. Of the patients investigated, 72% had normal carbon dioxide elimination, whereas in 23% hypercapnia could be avoided only by increasing the driving pressure. The prevalence of abnormal preoperative lung function test results predicts (sensitivity 76%, positive predictive value 27%) impaired carbon dioxide elimination during jet ventilation and rigid bronchoscopy.


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