Anaesthesia for Tracheobronchial Stent Insertion Using an Laryngeal Mask Airway and High-Frequency Jet Ventilation

Dolan, Anne; Moore, Michael F.

doi:10.1155/2013/950437

Cited by 7 publications

(6 citation statements)

References 2 publications

(5 reference statements)

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“…Moreover, the 27 F stent introducer sheath cannot pass the tracheal tube (8), and thus, the tracheal tube should be removed before the stent insertion, which can also result in procedure-related asphyxia. An effective ventilation model for patients with airway stenosis is sub-stenotic ventilation (5). In this study, our patients had airway stenosis involving the carina, and thus, the distal tip of LC 18×40 12×20 12×30 V II 83 95 96 2 65/F LC 22×40 13×10 13×25 IV I 79 96 95 3 66/M EC 18×50 11×20 11×30 IV I 86 97 94 4 75/M LC 18×40 12×20 12×30 V II 79 97 95 5 64/F LC 24×30 14×15 14×25 IV II 81 96 94 6 67/M LC 20×50 14×30 14×20 V I 80 94 94 7 59/M LC 22×50 12×30 12×20 IV I 84 97 95 LB, left bronchus; RB, right bronchus; M, male; LC, lung cancer; F, female; EC, esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

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Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience

Wei²,

Zhang³

et al. 2014

Diagn Interv Radiol

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PURPOSEWe aimed to report our preliminary results of subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex lower tracheal-carinal-main bronchial complex stenosis. MATERIALS AND METHODSSeven consecutive patients with lower tracheal-carinal-main bronchial complex stenosis underwent Y-shaped stent insertion under local anesthesia. During the procedure, subcarinal ventilation was performed using a 4 F angiographic catheter, and stent insertion was performed under the protection of ventilation. Data on technical success, clinical outcome, and follow-up were collected and analyzed. RESULTSSubcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia was technically successful in all patients without any major procedure-related complications. Seven stents were inserted in seven patients. Respiratory function improved in all patients, with the Hugh-Jones classification of respiratory status improving from grade IV-V before stenting to grade I-II after stenting. During the follow-up, one patient experienced re-stenosis of the stent. Average survival time was 185.7 days (range, 96-285 days) after the stenting procedure. CONCLUSIONSubcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia can be an effective, simple, and safe method for lower tracheal-carinal-main bronchial complex stenosis.

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Section: Discussionmentioning

confidence: 99%

“…This risk can be limited by lowering the oxygen flow, as it can reduce ventilation capacity and the resistance of expiration (5). To minimize the risk of barotrauma, we set the oxygen flow at a relatively low rate (2−3 L/min).…”

Section: Discussionmentioning

confidence: 99%

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience

Wei²,

Zhang³

et al. 2014

Diagn Interv Radiol

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show abstract

“…Presence of a bronchoesophageal fistula (Fig. 4), tracheoesophageal fistula, and tracheal compression from an invading esophageal malignant tumor might require setting up of a jet ventilator [24]. Presence of severe subglottic stenosis might prompt the anesthesiologist to the need of a smaller endotracheal tube as well as the need for a jet ventilator (Figs.…”

Section: Preoperative Evaluation and Preparationmentioning

confidence: 99%

Anesthesia for Advanced Bronchoscopic Procedures: State-of-the-Art Review

Goudra

Singh

Borle

et al. 2015

Lung

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The bronchoscopic procedures have seen a remarkable increase in both numbers and complexity. Although many anesthesia providers have kept pace with the challenge, the practice is varied and frequently suboptimal. Shared airway during bronchoscopy poses unique challenges. The available reviews have tried to address this lacuna; however, these have frequently dealt with the technical aspects of bronchoscopy than anesthetic challenges. The present review provides evidence-based management insights into anesthesia for bronchoscopy-both flexible and rigid. A systematic approach toward pre-procedural evaluation and risk stratification is presented. The possible anatomical and physiological factors that can influence the outcomes are discussed. Pharmacological principles guiding sedation levels and appropriate selection of sedatives form the crux of safe anesthetic management. The newer and safer drugs that can have potential role in anesthesia for bronchoscopy in the near future are discussed. Ventilatory strategies during bronchoscopy for prevention of hypoxia and hypercarbia are emphasized.

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“…All interventional bronchoscopies and an increasing number of diagnostic bronchoscopies are currently performed under general anesthesia for the comfort of the patient and the convenience of the operator. Supraglottic airway devices such as laryngeal masks [ 78 ] or i-gel [ 79 ] may be used instead of rigid bronchoscope insertion.…”

Section: Endobronchial Ultrasoundmentioning

confidence: 99%

The Role of Airway and Endobronchial Ultrasound in Perioperative Medicine

Votruba

Zemanová

Lambert

et al. 2015

BioMed Research International

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Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures.

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Anaesthesia for Tracheobronchial Stent Insertion Using an Laryngeal Mask Airway and High-Frequency Jet Ventilation

Cited by 7 publications

References 2 publications

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience

Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience

Anesthesia for Advanced Bronchoscopic Procedures: State-of-the-Art Review

The Role of Airway and Endobronchial Ultrasound in Perioperative Medicine

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