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

Abstract

Oxygen saturation and carbon dioxide values should be monitored during high-frequency jet ventilation (HFJV). Modern transcutaneous PCO2 (PtcCO2) 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