High Frequency Ventilation. Level 1 Mark Willing, RRT-NPS. Indications for High Frequency Ventilation. Failure of conventional mechanical ventilation to relieve respiratory acidosis
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The inhalation valve is placed as close to the patient as possible to deliver a “crisp” jet stream of fresh gas deep into the lungs.
A conventional ventilator is used in tandem to assist in oxygenation. Through manipulation of inspiratory time, PEEP, PIP, and rate, the mean airway pressure can be adjusted for optimal oxygenation and alveolar recruitment.
Passive exhalation requires a “lower” set rate (320-480 breaths/minute)
The small bore, clear tubing coming off the jet adapter must not be in a dependent position. Any secretions or water obstructing the tube will result in inaccurate pressure readings, damage the pressure transducer in the patient box, and/or will cause inaccurate pressure delivery to the patient.
The elbow on the in-line suction catheter should be positioned in such a manner that water condensation is not injected or lavaged down the airway.
The green jet tubing should be as straight as possible to reduce any dampening of the jet stream into the airway.
High frequency ventilation can provide enhanced gas exchange beyond what is capable with conventional ventilation.
The open-lung or high-volume lung strategies have recently proven to be most successful with and without the presence of active air-leaks.
High frequency ventilation may provide a means of a lung “protective” strategy for ventilating patients with poor lung compliance at risk for developing air-leak syndromes.
High lung volume strategy coupled with the relatively stable intrathoracic volume may reduce venous return to the heart and decrease blood pressure. Some patients may benefit from an increase in intravascular volume and/or administration of medications that increase blood pressure.
Procedures such as suctioning, position changes, and surfactant administration are to be left for some time at which an RRT can be present, even if it means before or after the designated “stim” time.