No abstract available.
Intermittent Positive-Pressure Ventilation* ; Tetanus*

Humans ; Infant, Newborn ; Intermittent Positive-Pressure Ventilation

To suggest the guide for indication of IV and NPPV for ARF of COPD, from January 1996 to May 1998, a prospective clinical trial was carried out in 57 COPD patients with ARF at the ICU of Bach Mai hospital. NPPV was indicated without severe complications. IV was indicated for 42 patients, the mortality rate decreased from 73% (1991-1994) to 28.5% (1996 - 1998). 2 patients in the IV group were extubated and successfully followed by NPPV. We conclude that, NPPV should be attempted before the decision of intubation or tracheotomy is made. IV with the moderate minute volume had very good effectiveness in severe ARFCOPD. We also suggest a guide for indications of NPPV and IV for ARFCOPD.
Intermittent Positive-Pressure Ventilation ; respiratory failure ; Pulmonary Disease, Chronic Obstructive

Currently conventional modes of controlled mechanical ventilation, such as intermittent positive pressure ventilation (IPPV) and continuous positive pressure ventilation (CPPV), with high volumes and low rates are utilized for the rhythmic inflation of the lungs. Basically the functional characteristics of these systems have not changed since Bjork and Engstrom first reviewed them in 1955 (Bjork and Engstrom 1955; Sjostrand 1983). Impairment of cardiovascular function and increasing the incidence of barotrauma with high airway pressure were problems which have needed to be solved. Thus respiratory support using high rates and low tidal volumes of ventilation was given. High-frequency ventilation(HFV) is not totally new idea, prototypes of it are found in nature in humming birds, insects and newborn babies. Moreover, HFV was reported in 1915 by Handerson who said that an adequate gas exchange could take place with a tidal volume less than the anatomical deadspace. But since the introduction of HFV in 1967, the basic concept of respiratory physiology has changed (Sjostrand and Smith 1983). HFV has received much attention in the last 20 years, resulting in a considerable accumulation of information. Many experimental and clinical studies have detailed the potential advantages of HFV but indicate that much work needs to be done to define and clarify the clinical role of these techniques and suggest that the standardized, reliable equipment with safety systems be developed. The purpose of this review is not to offer definite information for further investigation, but simply to provide background information for a better understanding of the experimental and clinical results recently achieved by many other researchers. Limited foci are as follows: 1) Definition and classification of HFV. 2) Technical developments and considerations. 3) Physiologic aspects of HFV. 4) Clinical applications. 5) Comparative studies between IPPV and HFV. 6) Problems and looking ahead.
Comparative Study ; High-Frequency Jet Ventilation ; High-Frequency Ventilation*/classification ; Human ; Intermittent Positive-Pressure Ventilation

Currently conventional modes of controlled mechanical ventilation, such as intermittent positive pressure ventilation (IPPV) and continuous positive pressure ventilation (CPPV), with high volumes and low rates are utilized for the rhythmic inflation of the lungs. Basically the functional characteristics of these systems have not changed since Bjork and Engstrom first reviewed them in 1955 (Bjork and Engstrom 1955; Sjostrand 1983). Impairment of cardiovascular function and increasing the incidence of barotrauma with high airway pressure were problems which have needed to be solved. Thus respiratory support using high rates and low tidal volumes of ventilation was given. High-frequency ventilation(HFV) is not totally new idea, prototypes of it are found in nature in humming birds, insects and newborn babies. Moreover, HFV was reported in 1915 by Handerson who said that an adequate gas exchange could take place with a tidal volume less than the anatomical deadspace. But since the introduction of HFV in 1967, the basic concept of respiratory physiology has changed (Sjostrand and Smith 1983). HFV has received much attention in the last 20 years, resulting in a considerable accumulation of information. Many experimental and clinical studies have detailed the potential advantages of HFV but indicate that much work needs to be done to define and clarify the clinical role of these techniques and suggest that the standardized, reliable equipment with safety systems be developed. The purpose of this review is not to offer definite information for further investigation, but simply to provide background information for a better understanding of the experimental and clinical results recently achieved by many other researchers. Limited foci are as follows: 1) Definition and classification of HFV. 2) Technical developments and considerations. 3) Physiologic aspects of HFV. 4) Clinical applications. 5) Comparative studies between IPPV and HFV. 6) Problems and looking ahead.
Comparative Study ; High-Frequency Jet Ventilation ; High-Frequency Ventilation*/classification ; Human ; Intermittent Positive-Pressure Ventilation

In 10 anesthetized and paralyzed rabbits, cardiovascular variabled(blood pressure, pulse rate), rectal temperature and arterial blood gase tension were investigated during high frequency oscillatory ventilation(about 17hz). During high frequency oscillation(HFO) blood pressure, rectal temprerature and blood gas tension remained stable and were not different from the control values( intermittent positive pressure ventilation IPPV). The PaO2/FIO2 ratio remained unchanged during the experiment in spite of changing airway pressure. We observed that HFO provided adequate ventilation and oxygenation without altering cardiovascular dynamics. High frequency oscillatory ventilation appears to be a promising new way of achieving gas exchange with minimal risk of barotrauma to the lung.
Barotrauma ; Blood Pressure ; Intermittent Positive-Pressure Ventilation ; Lung ; Oxygen ; Rabbits ; Ventilation*

BACKGROUND: The purpose of this study was to measure lumbar epidural pressure (EP) during the insertion of a Tuohy needle under general anesthesia and to evaluate the influence of airway pressure on EP. METHODS: Lumbar EP was measured directly through a Tuohy needle during intermittent positive pressure ventilation in fifteen patients. Mean and peak EP were recorded after peak inspiratory pressures (PIP) of 0, 15, and 25 cmH2O. RESULTS: All measured lumbar EPs were positive, with the pressure increasing during inspiration and decreasing during expiration. Median EP was 6.0 mmHg (interquartile range, 4.0-8.0) at 0 cmH2O of PIP, 6.5 mmHg (4.5-8.5) at 15 cmH2O, and 8.5 mmHg (6.0-10.5) at 25 cmH2O, increasing significantly at 15 cm H2O PIP, and further increasing at 25 cmH2O (P < 0.001). CONCLUSIONS: We demonstrate the influence of increased airway pressure on lumbar EP measured directly through a Tuohy needle. Lumbar EPs were positive, and increasing PIP levels significantly increased lumbar EP.
Anesthesia, General ; Humans ; Intermittent Positive-Pressure Ventilation ; Needles ; Positive-Pressure Respiration

In order to reduce the serious complications associated with invasive mechanical ventilation, non-invasive ventilation (NIV) has increasingly been chosen as the primary ventilation in preterm infants with respiratory distress syndrome (RDS). In the last 4 decades, nasal continuous positive airway pressure (NCPAP) has been as a main, or even the only mode of NIV in preterm infants with RDS. In the recent decade, improvements in sensors and nasal airway interfaces have resulted in the introduction of a variety of other new types of NIV, such as nasal intermittent positive pressure ventilation (NIPPV), bi-level positive airway pressure (BiPAP). Subsequent studies have shown that some new modes may be more superior to NCPAP in preterm infants with RDS. In order to further understand the application of various NIV modes, we review literatures about all kinds of NIV as a primary mode of ventilation in preterm infants with RDS.
Continuous Positive Airway Pressure ; Humans ; Infant, Newborn ; Infant, Premature ; Intermittent Positive-Pressure Ventilation ; Noninvasive Ventilation ; Respiratory Distress Syndrome, Newborn ; therapy

BACKGROUND: In some cases of one-lung ventilation (OLV), hypoxemia may occur secondarily to the obligatory right to left transpulmonary shunt through the collapsed lung. We investigated the efficacy of high frequency jet ventilation (HFJV) to the non-dependent lung which rendered to be manually collapsed by surgeon and not to be reinflated, in improving systemic oxygenation and ventilation during OLV while ventilating the dependent lung with intermittent positive pressure ventilation. METHODS: Investigation was carried out on 20 ASA 2 or 3 patients who underwent thoracotomy in lateral decubitus position. The patients were randomly allocated into HFJV group (n = 11) or CPAP group (n = 9). In HFJV group, 20 minutes after OLV began, HFJV with driving pressure 1.0 bar, Ti 30%, and frequency 150 cycles/min, was applied to the non-dependent lung. In CPAP group, 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. We compared the changes of PaO2, PaCO2, AaDO2 and pulmonary shunt, before and after HFJV or CPAP was applied to the non-dependent lung during OLV. RESULTS: AaDO2 and pulmonary shunt were decreased significantly and therefore, PaO2 was increased significantly when HFJV was applied to the non-dependent lung (P < 0.05, respectively). PaO2, AaDO2 and pulmonary shunt were not improved after 5 cmH2O of CPAP was applied to the non-dependent lung without re-inflation. In HFJV group, PaCO2 measured after HFJV was not decreased significantly compared with that before HFJV. CONCLUSIONS: HFJV to the non-dependent lung during OLV improved systemic oxygenation, even after the non-dependent lung collapsed completely but did not enhance CO2 elimination. 5 cmH2O of CPAP to the non-dependent lung, which was completely collapsed and not re-inflated, did not improve systemic oxygenation.
Anoxia ; High-Frequency Jet Ventilation* ; Humans ; Intermittent Positive-Pressure Ventilation ; Lung* ; One-Lung Ventilation* ; Oxygen* ; Thoracotomy ; Ventilation

This patient had received antihypertensive therapy, which was followed by severe acute hypertension (300/260 mmHg), due to inadequate ventilation after anesthesia. Acute hypertensive treatment was performed successfully by lowering blood pressure with chlorpromazine, 25 mg and valium, 10 mg by intravenous injection, with intermittent positive pressure breathing.
Anesthesia ; Blood Pressure ; Chlorpromazine ; Diazepam ; Humans ; Hypertension ; Injections, Intravenous ; Intermittent Positive-Pressure Breathing ; Postoperative Period* ; Ventilation