Air entrainment during high-frequency jet ventilation in a model of upper tracheal stenosis †

Abstract

The results suggest that the high airway pressures generated during ASV are the consequence of air entrainment and this effect, although reduced slightly, is maintained in the presence of the model pharynx. In contrast to the previous work, no significant entrainment occurred during BSV. If applicable to patients, these data suggest that ASV HFJV should be avoided in small diameter stenoses, but provides more efficient gas delivery and greater distending pressures with larger stenoses. BSV HFJV produces lower distal pressures and more consistent oxygen concentrations of injected gas across a range of stenosis diameters.

Influence of Tracheal Obstruction on the Efficacy of Superimposed High-frequency Jet Ventilation and Single-frequency Jet Ventilation

“…32 Interestingly, p a o 2 was only mildly reduced for the downsizing step from 8-to 4-mm stent ID (i.e., 75% obstruction). 32 Interestingly, p a o 2 was only mildly reduced for the downsizing step from 8-to 4-mm stent ID (i.e., 75% obstruction).…”

“…From their results from bench studies, some claim that detrimental intrapulmonary pressures occur during prestenotic JV, 32,33 whereas others report intrapulmonary pressures within acceptable limits. From their results from bench studies, some claim that detrimental intrapulmonary pressures occur during prestenotic JV, 32,33 whereas others report intrapulmonary pressures within acceptable limits.…”

Tracheal stenosis and reconstructive surgery: Our experience on anesthesia and airway management

“…During the procedure these three different routes (upper endotracheal tube, HFJV catheter, tracheostomy) and three techniques (conventional ventilation, HFJV, cross-field ventilation) were applied in an alternating manner to optimize surgical conditions. [10] Gas exchange failure (hypercapnia and hypoxia) during HFJV is common as reported previously and can limit its use despite the transient character of these complications. [11] Although hypercapnia was stated as the most frequent complication of the method, we did not observe any problem regarding CO 2 retention during HFJV.…”

Emergency ventilation with the Ventrain® through an airway exchange catheter in a porcine model of complete upper airway obstruction

“…Admittedly, in a situation where the upper airway is not critically occluded, high-frequency jet ventilation might be more efficient. We would expect this to be true if the diameter of the patient’s airway is more than twice the diameter of the AEC, as it would minimize the risk of pulmonary hyperinflation 18. In clinical practice, it may be difficult to choose the optimal mode of rescue ventilation, and the choice would be dictated by the a priori risk of tissue swelling or hematoma and respective clinical signs.…”