Effects of Orifice Plate as a Flow Sensor in an Endotracheal Tube on the Ability of Elimination CO2 during HFJV—Animal Study
Round 1
Reviewer 1 Report
The paper addresses a very topical issue, that of using high-frequency ventilation. High-Frequency Jet Ventilation (HFJV) is rarely used in Europe because jet ventilators are used in combination with a standard ventilator and don’t provide information on the supplied tidal volumes. Also, the flow monitoring is absent.
The author proposes an orifice plate as a flow-sensor for HFJV.
The paper is well organized, and the length is appropriate. The title is chosen correctly, and the abstract provide sufficient information to give a clear idea of what to expect from the paper.
The study was approved by the Ethics Committee of 1st Medical Faculty of Charles University in Prague.
The technical depth of the paper meets the requirements for a scientific article published in a quality journal.
Author Response
Dear reviewer,
Thank you for your time and effort to increase the quality of this paper.
I implemented all of the recommendations and suggestions from you. All changes are visible in tracking changes.
Best Regards
Petr Kudrna
Reviewer 2 Report
I have a couple of concerns, why did 3 rabbits die? Was this related to intubation the ventilation technique?
Did the other 8 rabbits survive? where they fully recovered? or was there lung injury?
In the picture the rabbit is shown in a lateral position, why was this position chosen? Rabbits commonly rest in sternal, I would have chosen a sternal position as this is more physiologically normal. Would not worry about atelectasis in the lateral position affecting the blood gas values and the ability to ventilate?
Author Response
Dear reviewer,
Thank you for your time and effort to increase the quality of this paper.
To your questions:
Why did 3 rabbits die? Was this related to intubation the ventilation technique?
PK:
Intubation, respectively intubation methods did not cause the death of 3 rabbits. In all cases, there were circulatory complications associated with the management of anesthesia, respectively - reaction to anesthesia.
Did the other 8 rabbits survive? where they fully recovered? or was there lung injury?
PK:
A total of 8 rabbits underwent the experiment in all 3 phases. The study of rabbits after HFJV was not planned in the experiment. The rabbits were handled according to a protocol approved by the Ethics Committee. The experimental approval document was submitted to Applied Sciences.
Animal experiments were conducted at the Institute of Physiology of the 1st Faculty of Medicine, Charles University. The Expert Commission approved them for Laboratory Animals of the 1st Medical Faculty of Charles University under Act No. 246/1992 Coll. on the protection of animals against cruelty and its subsequent amendment according to Act No. 77/2004 Coll. of the Czech Republic, under the number MSMT - 14076 / 2015-15 (In-fluence of the HFJV neonatal orifice plate on the exchange of respiratory gases).
In the picture, the rabbit is shown in a lateral position; why was this position chosen? Rabbits commonly rest in sternal, I would have chosen a sternal position as this is more physiologically normal. Would not worry about atelectasis in the lateral position affecting the blood gas values and the ability to ventilate?
PK:
Thank you for a very good suggestion.
The positioning of the rabbits was solved before the experiment itself.
HFJV ventilation technique is used in clinical practice, especially in inhomogeneous lung diseases of immature newborns. The lateral position of the rabbit thus contributed to the creation of inhomogeneity. On the other hand, in HFJV, the lungs are inflated with PEEP pressure, which prevents the immediate formation of atelectasis. All 3 phases of the experiment represented about 60 minutes, and I do not think extensive atelectasis.
I believe I have fully answered your questions.
I also implemented all of the recommendations and suggestions from other reviewers and moderated the English and typography. All changes are visible in tracking changes.
Thank you again for your time.
Best Regards
Petr Kudrna
Reviewer 3 Report
Dear authors,
Please consider the following suggestions of improvement:
- Please include a paragraph at the end of introduction describing the paper structure;
- A paragraph between section 2 and 2.1 should be included describing briefly the contents of the overall section 2;
- Figures 3,4, 5, 8 should be presented in the text before the figure;
- Please include a paragraph at the end of conclusion with some future work suggestions;
- More recent references should be included as as only 2 of them are in a 5 year range.
Author Response
Dear reviewer,
Thank you for your time and effort to increase the quality of this paper. I implemented all of the recommendations and suggestions from you. All changes are visible in tracking changes.
Please include a paragraph at the end of introduction describing the paper structure;
I added a paragraph at the end of the introduction. The structure of the paper is presented.
A paragraph between section 2 and 2.1 should be included describing briefly the contents of the overall section 2;
I added a paragraph between sections 2 and 2.1.
Figures 3,4, 5, 8 should be presented in the text before the figure;
I added a link to the figures.
Please include a paragraph at the end of the conclusion with some future work suggestions;
I added a paragraph with an estimation of future work in this field.
More recent references should be included as only 2 of them are in a 5 year range
I updated a list of references.
Best Regards
Petr Kudrna
Round 2
Reviewer 2 Report
the manuscript is improved and the authors have addressed the concerns of the reveiwers.
