Clinical Uses of High Frequency Jet Ventilation in Anaesthesia

Giunta, F; Chiaranda, Maurizio; Manani, G; Giron, Giampiero

doi:10.1093/bja/63.7.102

Cited by 21 publications

(11 citation statements)

References 10 publications

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“…Fourth, the HFJV can be applied. HFJV has been shown to be appropriate in patients with disrupted major airways, including patients with tracheal and bronchial problems (3, 6-8). Because of the continuous high frequency outflow of gases, HFJV provides the surgeon with an uninterrupted surgical field and lessens the risk of aspiration of blood into the airways distal to the resection (2).…”

Section: Discussionmentioning

confidence: 99%

High Frequency Jet Ventilation of One Lung using a Bronchial Blocker of Univent during Carinal Resection

et al. 2010

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Airway management during carinal resection should provide adequate ventilation and oxygenation as well as a good surgical field, but without complications such as barotraumas or aspiration. One method of airway management is high frequency jet ventilation (HFJV) of one lung or both lungs. We describe a patient undergoing carinal resection, who was managed with HFJV of one lung, using a de-ballooned bronchial blocker of a Univent tube without cardiopulmonary compromise. HFJV of one lung using a bronchial blocker of a Univent tube is a simple and safe method which does not need additional catheters to perform HFJV and enables the position of the stiffer bronchial blocker more stable in airway when employed during carinal resection.

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Section: Discussionmentioning

confidence: 99%

High Frequency Jet Ventilation of One Lung using a Bronchial Blocker of Univent during Carinal Resection

et al. 2010

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“…The insertion of the fight bronchial blocker with subsequent right lung collapse in the fLrst part of the operation not only facilitated surgical exposure of the carina, but also served as a test of the adequacy of oxygenation during one-lung conventional IPPB. The ventilatory variables of HFJV for the left lung were adjusted according to our previous experience with the technique and recommendations of others, s, 6,8,20,21 We were unable to determine 'the definite cause of decrease in oxygen saturation, which occurred approximately ten mintues after the onset of HFJV to the left lung, but we suspected it was either compression of the left lung or bleeding. In this situation there were several options for the rapid relief of hypoxia: l Increase the driving gas pressure (DGP).…”

Section: Discussionmentioning

confidence: 99%

Carinal resection with two high-frequency jet ventilation delivery systems

1993

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Case report A 76-yr-old man was admitted for investigation of progressive hoarseness and shortness of breath on moderate exertion. Laryngoscopy, bronchoscopy and mediastinoscopy revealed a squamous cell carcinoma of the right vocal cord as well as a squamous cell carcinoma of the carina adjacent to the origin of the left main bronchus. There was a history of cigarette smoking and exposure to coal and gold dust, as well as mild hypertension treated with enalapril 5 mg od. He had undergone abdominal aortic aneurysm repair one year previously.Physical examination was unremarkable. Blood pressure was 130/60 mmHg. Haemoglobin, electrolyte and creatinine concentrations, liver function tests, chest x-ray and ECG were all within normal limits. His preoperative arterial blood gas analysis breathing room air showed: pH 7.44; PCO2 5.06 kPa (38 mmHg); PO2 I0.8 kPa (81 mmHg); HCO3 26 mmol-L -I, 02 sat 96%. Pulmonary function tests revealed a mild to moderate airflow limitation with hyperinflation and also moderate impairment of lung diffusion.It was decided to resect the carinal tumour first, and subsequently to irradiate the laryngeal lesion. The patient was scheduled for excision and reconstruction of the carina through a right posterolateral thoracotomy. Conduct of anaesthesiaThe patient received premedication with glycopyrrolate 0.2 mg ira. Following placement of a lumbar epidural catheter for postoperative analgesia, general anaesthesia was induced with propofol 100 mg and tracheal intubation was facilitated with succinylcholine 120 mg. A #14 F Fogarty occlusion catheter, used as a bronchial blocker, was inserted into the right main bronchus followed by intubation of the trachea with a 9.0 mm endotracheal tube. The position of both was confumed by fibreoptic bronchoscopy.Initally, anaesthesia was maintained with oxygen 40%, N20, halothane, fentanyl 100 Isg and muscle relaxation

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“…Aber auch in der Thoraxchirurgie gibt es eine Reihe von Einsatzmöglichkeiten, beispielsweise Trachearesektionen oder komplizierte Eingriffe im Bereich der Carina (sleeve pneumonectomy) [6]. Erfolgreich angewandt wurde die HFJV außerdem in Situationen, in denen hohe Beatmungsdrücke unerwünscht sind, z.…”

Section: Diskussionunclassified

Einseitige High-Frequency-Jet-Ventilation als Ergänzung der Ein-Lungenbeatmung bei thoraxchirurgischen Eingriffen

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Vorweg³

et al. 2001

Der Anaesthesist

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We report two cases where surgery on the right lung had to be performed for resection of a malignoma. In both cases, function of the left lung was severely restricted. In the first patient, the volume on this side was reduced by around 50% as the result of a recently performed upper lobe resection. In the second patient, perfusion of the left lung accounted for only 18% of the total lung perfusion. On the basis of these changes we considered conventional one-lung ventilation impracticable and performed surgery using differential lung ventilation. The dependent (left) lung was ventilated by intermittent positive pressure ventilation (IPPV), where the tidal volume in the first patient had to be reduced to 200 ml because of high airway pressures. Ventilation of the non-dependent (right) side was performed simultaneously in both patients by means of high frequency jet ventilation (HFJV). Under this procedure arterial O2 saturation ranged from 96 to 100%, and arterial CO2 partial pressure was 45 mmHg. Surgery was not hindered by ventilation, the postoperative progress was also without complications. The case reports show that with the help of the ventilation regime described (operated side: HFJV, non-operated side: IPPV) lung surgery can be successfully performed on patients who are unsuitable for conventional one-lung ventilation for functional reasons.

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Clinical Uses of High Frequency Jet Ventilation in Anaesthesia

Cited by 21 publications

References 10 publications

High Frequency Jet Ventilation of One Lung using a Bronchial Blocker of Univent during Carinal Resection

High Frequency Jet Ventilation of One Lung using a Bronchial Blocker of Univent during Carinal Resection

Carinal resection with two high-frequency jet ventilation delivery systems

Einseitige High-Frequency-Jet-Ventilation als Ergänzung der Ein-Lungenbeatmung bei thoraxchirurgischen Eingriffen

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