Complication of Jet Ventilation during Microlaryngeal Surgery

Superimposed high-frequency jet ventilation (SHFJV) for endoscopic laryngotracheal surgery in more than 1500 patients

“…In patients with reduced respiratory reserves, for example decreased lung compliance or increased resistance, massive obesity, or massive obstructive pulmonary disease, the time for high-frequency jet ventilation and adequate gas exchange is limited. 21 This may lead to CO 2 retention. When the transtracheal or translaryngeal access is used, CO 2 elimination usually occurs because a lower jet frequency and increased volumes of the single jet gas impulses are used.…”

The Utility of Routine Chest Radiography Following Jet Ventilation in Elective Laryngotracheal Surgery

“…Although complications from jet ventilation are rare, they deserve specific attention as they can be immediately life threatening due to impaired gas exchange or cardiac output. Possible complications include barotrauma, loss of airway, aspiration, necrotizing tracheobronchitis, and stomach insufflation 3,4,11,12,13,14 . Barotrauma can result from intrapulmonary air trapping either as a result of inadequate expiratory time, an airway mass leading to ball‐valve physiology, or excessive driving pressures.…”

“…This may be particularly true when manual jet ventilation is used from a wall source without any regulatory valve system. This in turn can develop into pneumomediastinum or pneumothorax, both of which can lead quickly to cardiac failure if unrecognized 12 . In addition, loss of airway can result from laryngospasm in the absence of an endotracheal tube.…”