British journal of anaesthesia
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Comparative Study
High frequency jet ventilation v. manual jet ventilation during bronchoscopy in patients with tracheo-bronchial stenosis.
Six patients with airway stenosis were submitted to bronchoscopy under general anaesthesia. Each was ventilated with a gas mixture of 50% oxygen and nitrogen using successively manual jet insufflation (JV) using the Sanders technique at 20 b.p.m., and high frequency jet ventilation (HFJV) at rates of 150, 300 and 500 b.p.m. ⋯ At the faster rate some degree of hypoxaemia and hypercarbia were noted. The correlation between PaCO2 and transcutaneous carbon dioxide tension was satisfactory.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pattern of change of bronchomotor tone following reversal of neuromuscular blockade. Comparison between atropine and glycopyrrolate.
Specific airways conductance (s. Gaw) was measured using the forced airflow oscillation method, to study the effect of two regimens, commonly used for the reversal of neuromuscular blockade, on bronchomotor tone. Patients who had received neuromuscular blockers and had undergone elective surgery were randomly allocated to receive neostigmine 50 microgram kg-1 given concurrently with either atropine 20 microgram kg-1 (10 patients) or glycopyrrolate 10 microgram kg-1 (10 patients). ⋯ Gaw between the two groups, higher values being found in the atropine group. At 10 min, no significant difference was seen between the groups, although both showed a significant decrease in s. Gaw compared with baseline values (P less than 0.05).
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Comparative Study
Manual jet ventilation v. high frequency jet ventilation during laser resection of tracheo-bronchial stenosis.
Manual jet ventilation (20 b.p.m.) and high frequency jet ventilation (300 b.p.m.) were compared during laser resection of tracheo-bronchial stenosis under general anaesthesia. Both methods provided similar blood-gas tensions at the 10th min of surgery in patients with tracheal stenosis. In patients with bronchial stenosis high frequency jet ventilation resulted in modest hypercarbia and manual jet ventilation appeared to be the preferred method in these particular patients.
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The effect of carrier gas composition on the output of six anaesthetic vaporizers was studied using oxygen, nitrous oxide, helium and argon as the carrier gases. Vaporizer output was measured with an MGA 200 mass spectrometer and a Riken refractometer and, in addition, the pressure decrease across each vaporizer was determined simultaneously. ⋯ The possible reasons for the changes in steady state output are discussed in relation to the construction of each vaporizer. The addition of nitrous oxide to the carrier gas produced changes of clinical significance only when the vaporizers were used at extreme dial settings and flow rates.
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A ventilator, of new design, is described which has been evaluated on a lung model and in animals. It is simple, versatile, inexpensive and easy to sterilize. A single breathing tube is used in which the respiratory gas is introduced near the patient's airway while a jet in a more distal part of the tube drives the respiratory gas into the patient's lungs. ⋯ It can be used for any age group with any desired respiratory gas, and is suitable for use in the operating theatre and the intensive care unit. As there are no valves in the breathing system, which is open to the atmosphere at all times, complicated systems for synchronizing the machine with spontaneous breathing are not required. PEEP, NEEP, CPAP and IMV are applied easily.