No abstract

Since 1982, we have used HFJV as one of the routine ventilatory modes. The purposes of it's application are (1) improvement of oxygenation, (2) lowering of the maximum inspiratory pressure and (3) physiotherapy.We examined HFJV for these 3 criteria and the results are as follows. 1. HFJV improves oxygenation, PaO2 elavats, A-a DO2 decreases and respiratory index also decreases. Using mongreal dogs, we made pulmonary edema model by administration of 0.07-0.1ml/kg oleic acid via S-G catheter. Then we compared HFJV and CMV under the condition of same mean airway pressure. Almost all parameters, such as PaO2, A-a DO2, respiratory index and cardiac index were nearly same under this condition. We concluded only PEEP effect of HFJV results in improvement of oxygenation.2. Lowering of the maximum inspiratory pressure is effective for prevention and treatment of barotrauma.3. HFJV for physiotherapy is most effective. It's useful treatment method to not only usual atelectasis but also intractible status asthmatics. Soon after application of HFJV to these patients, we could suction large amounts of secretions and then they improved clinically.Especially HFJV was effective to the intractible status asthmaticus patients, who don't respond existing vigorous treatments such as administration of large amounts of fluid, xantines, steroids, epinephrine and isoproterenol, conventional mechanical ventilation and inhalation anesthesia. We think HFJV solves mucous plug by internal vibration and for that reason it is effective to the intractible status asthmatics.

The effects of droperidol combined with pentazocine and with fentanyl on the pulmonary hemodynamics were investigated in intact dogs anesthetized with urethane ehloralose, and the results were compared with those of each analgesic alone. Mean pulmonary arterial pressure and pulmonary driving pressure remained almost unchanged after droperidol and pentazocine.Pulmonary vascular resistance decreased significantly, and pulmonary vascular compliance and its radius tended to increase. These results indicate that droperidol counteracts the vasoconstrictive action of pentazocine on the pulmonary hemodynamics.On the contrary, almost,, all the parameters of the pulmonary hemodynamics after droperidol and fentanyl changed to similar directions to those after fentanyl alone. Droperidol seemed not to modify but to exaggerate the pulmonary circulatory effects of fentanyl. pulmonary hemodynamics; droperidol; pentazocine; fentanyl Previously we reported that pentazocine produced pulmonary hypertension due to its direct vasoconstriction in anesthetized dogs, while fentanyl lowered pulmonary arterial pressure (Takahashi and Iwatsuki 1974). In clinical anesthesia, these analgesics are often used in combination with droperidol as neuroleptanesthesia (Iwatsuki et al. 1971). Therefore, the present study was undertaken to investigate the pulmonary circulatory effects of droperidol combined with pentazocine and with fentanyl, and the results were compared with those of each analgesic alone in the previous report. MATERIALS AND METHODSFourteen mongrel dogs were anesthetized with ethyl carbamate (800 mg/kg) and chloralose (60 mg/kg). Following endotracheal intubation, respiration was controlled with pure oxygen using a volume-preset respirator (AIKA R-50). End-tidal CO2 content was maintained at approximately 5% with the Beckman medical gas analyzer.Mean arterial pressure, mean pulmonary arterial pressure (MPAP) and mean left atria] pressure (MLAP) were measured by electric manometers (Nihon Kohden MP-3A), and they were recorded on a polygraph. Heart rate was read from the recorder. Cardiac