Preventing the Spread of Aerosol Infection During Application of High-Frequency Jet Ventilation by Mask
High-frequency jet ventilation by mask (HFJV-M) is another form of noninvasive ventilation (NIV) and a new approach to improving patient–ventilator synchronization during NIV. This method uses a supraphysiological frequency of 120 breaths/min, which does
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Preventing the Spread of Aerosol Infection During Application of HighFrequency Jet Ventilation by Mask Viliam Donic, Pavol Torok, and Zoltan Tomori
Keywords
HFJV • Protective lung ventilation • NIV • High-risk infections and mass casualty events
6.1
Introduction
High-frequency jet ventilation by mask (HFJV-M) is another form of noninvasive ventilation (NIV) and a new approach to improving patient–ventilator synchronization during NIV. This method uses a supraphysiological frequency of 120 breaths/ min, which does not interfere with the patient’s spontaneous breathing. Lung receptors are not able to respond because they are not stimulated by this frequency. HFJV-M does not provoke cough, nor does the patient fight the ventilator. The ventilator (Paravent; Kalas Medical Ltd., Slovakia) uses a special patented pressure generator with an open central receiving channel [1]. The machine is commercially available and represents a breakthrough in NIV. It addresses almost all major disadvantages or concerns regarding NIV in patients with a high-risk infection and is advantageous in other situations. There are several reasons for its usefulness: Its construction and principle are simple, and it is not expensive. The ventilator does not require synchronization with the patient, who is simply connected with the ventilator by a naso-oral nonvented mask. No other signal from the patient, catheter, or nasal tubing is necessary. The ventilation circuit is sealed, and a nonvented orofacial mask is connected to a specially designed pressure generator. The system is open to the atmosphere only during inspiration. The patient can breathe spontaneously or switch over to being completely dependent on the ventilator if necessary, V. Donic (*) • P. Torok • Z. Tomori Department of Physiology and Sleep Laboratory, Faculty of Medicine, University of P.J. Safarik, Kosice, Slovakia e-mail: [email protected] A.M. Esquinas (ed.), Noninvasive Ventilation in High-Risk Infections and Mass Casualty Events, DOI 10.1007/978-3-7091-1496-4_6, © Springer-Verlag Wien 2014
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“T” piece with One way valves Tubing 22 mm
Inspiratory flow
Filter
Expiratory flow
MNJI
Patient (Mask, ET tube ...)
Fig. 6.1 To prevent airborne infection spread, it is necessary during HFJV-M or any other HFJV application to use an expulsion set. It is connected to a pressure generator (MNJI), and the expiratory flow is directed through an appropriate bacterial/viral filter to prevent contamination of the environment by expired infected aerosol droplets
without interruption or use of any trigger. The exhaled air passed through a highefficiency particulate air (HEPA) filter, where the aerosol is condensed and infection agents are trapped (Fig. 6.1). The system can be used even during a bioterrorist attack because its ventilation is effective in an atmosphere of toxic gases or bacterial contamination. One of the advantages of this method is that it performs protective lung ventilation with a significant reduction in ventilator-induced lung injur
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