High Frequency Ventilation with Topical Anaesthesia as an Aid to Physiotherapy

High frequency ventilation (HFV) with topical anaesthesia and without tracheal intubation has been used in our hospital in patients with chronic obstructive lung disease and progressive CO2-retention, due to exacerbations. In these patients conventional mechanical ventilation has several disadvantages. It often requires general anaesthesia or sedation, is associated with additional risks and usually it takes several days to wean the patient off the respirator. 1)It was thought that in this kind of patients HFV with topical anaesthesia might improve alveolar ventilation and reduce the need for conventional mechanical ventilation. However, HFV led to excessive mobilization of sputum and these patients with severely compromised pulmonary function and flaccid lungs had serious difficulty in handling large quantities of sputum. 2)