Hostname: page-component-7bb8b95d7b-495rp Total loading time: 0 Render date: 2024-09-12T15:27:13.312Z Has data issue: false hasContentIssue false
  • English
  • Français

Intrapulmonary Drug Administration during High Frequency Jet Ventilation

Published online by Cambridge University Press:  28 June 2012

M. Klain ,
H. Keszler ,
U. Nordin  and
R. Kalla
M. Klain
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
H. Keszler
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
U. Nordin
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
R. Kalla
Affiliation:
From the Department of Anesthesiology and Medicine, Montefiore and VA Hospitals and Department of Otolaryngology, Eye and Ear Hospital,University of Pittsburgh, School of Medicine, Pittsburgh PA 15213, USA.
Get access Rights & Permissions [Opens in a new window]

Extract

It has previously been demonstrated that high frequency jet ventilation, via transtracheal cricothyroid membrane puncture, can maintain good gas exchange even during cardiopulmonary resuscitation. When the upper airways were filled with fluid, aspiration could be prevented without a cuffed endotracheal tube when respiratory rates of 100/min or higher and an inspiratory time of at least 50% were used. We have also shown that cricothyroid membrane puncture is relatively easy to perform and produces less tracheal damage than a cuffed endotracheal tube.

In one of our studies, cardio-green dye was mixed into the jet using a Y-connector on the proximal end of the angiocath cannula (Figure 1). In two dogs, the distribution of the dye in the lungs was investigated. It was found that nebulized dye was transported by the jet stream to the most distant bronchi which could be observed. On subsequent autopsy, the dye was found in the most peripheral airways.

Type
Part II: Clinical Care Topics
Information
Prehospital and Disaster Medicine , Volume 1 , supplement S1: Disaster Resuscitology , 1985 , pp. 220 - 222
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Klain, M, Keszler, H, Brader, E. High frequency jet ventilationin CPR. Crit Care Med 1981;9:421–422.CrossRefGoogle Scholar
2. Keszler, H, Klain, M, Nordin, U. High frequency jet ventilation prevents aspiration during cardiopulmonary resuscitation. Crit Care Med 1981;9:161.CrossRefGoogle Scholar
3. Klain, M, Miller, J, Kalla, R. Emergency use of high frequency jet ventilation. Crit Care Med 1981;19:160.CrossRefGoogle Scholar
4. Redding, JS, Asuncion, JS, Pearson, JW, Effective routesof drug administration during cardiac arrest. Anesth Analg 1967;46:253.CrossRefGoogle ScholarPubMed
5. Roberts, JR, Greenberg, MI, Baskin, SI. Endotracheal epinephrine incardiorespiratory collapse. JACEP 1979;8:515.CrossRefGoogle ScholarPubMed
6. Elam, JO, The intrapulmonary route for CPR drugs. Advances in Cardiopulmonary Resuscitation, New York: Springer-Verlag, 1977; p. 132.Google Scholar
7. DalSanto, G, Nonrespiratory functions of the lung and anesthesia. International Anesthesiology Clinics 1977 15:4,61.Google Scholar
8. Roberts, JR, Greenberg, MI, Knaub, MA et al. Blood levels following intravenous and endotracheal epinephrine administration. JACEP 1979;8:53.CrossRefGoogle ScholarPubMed
9. Abou-Madi, M, Keszler, H, Yacoub, JM, A method for prevention of cardiovascular reactions to laryngoscopy and intubation. Canad Anaesth Soc J 1975;22:316.CrossRefGoogle ScholarPubMed
10. Abou-Madi, M, Keszler, H, Yacoub, JMCardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Canad Anaesth Soc J 1977;24:12.Google ScholarPubMed
11. Keszler, H, Carroll, GC. Intracardiac injections during resuscitation. JAMA 1981;246:123.CrossRefGoogle Scholar