Evaluation of Supraglottic Jet Oxygenation and Ventilation in 105 Patients During Bronchoscopy Using the Twinstream® Microprocessor-Controlled Jet Ventilator and the Wei Nasal Jet® Tube

Abstract

is the inventor of the Wei Nasal Jet Tube (Wei Nasal Jet or WNJ), which was used to generate SJOV in this study Conflict of interest:None declared Background:The Twinstream ® ventilator is a microprocessor-controlled electric jet ventilator that allows the simultaneous application of 2 different jet streams, one at low frequency and one at high frequency to result in pulsatile bilevel (p-BLV) mode of ventilation. This study aimed to evaluate supraglottic jet oxygenation and ventilation in 105 patients during bronchoscopy using the Twinstream ® microprocessor-controlled jet ventilator and the Wei Nasal Jet ® (WNJ) tube. Material/Methods:Patients were randomly divided into 2 parallel groups (N=50 per group): group W using the WNJ tube and group M using an endoscopic face mask connected to Twinstream ® microprocessor-controlled jet ventilator under monitored anesthesia care. Arterial blood gas was examined and recorded 15 minutes after the initiation of procedure. The demographic and clinical characteristics, procedure duration, doses of anesthetics, and adverse events in the 2 groups were also recorded. Results:The arterial partial pressure of carbon dioxide (PaCO 2 ) (P=0.006) and lactic acid (P=0.001) were significantly lower, while pH (P=0.024) was significantly higher than in the group M. Pearson analysis showed that PaCO 2 was significantly correlated with ventilation tools (P=0.006) and procedure duration (P=0.003). Multiple linear regression analysis showed that ventilation tools and procedure duration were both independent influencing factors (P=0.006, P=0.002). Conclusions:Supraglottic jet oxygenation and ventilation using the WNJ tube can reduce PaCO 2 and had advantages in enhancing oxygenation and ventilation function in patients during bronchoscopy intervention therapy under monitored anesthesia care.

Risk factors for pharyngalgia and xerostomia undergoing supraglottic jet oxygenation and ventilation in gastrointestinal endoscopy: a retrospective study

“…Gupta suggested clearly that pharyngalgia/xerostomia was the most common event during SJOV, and this event has been well demonstrated in clinical observational investigators 13 – 15 , 18 , 19 . It is currently believed to be related to cold and dry gas.…”

“…SJOV via WNJ has been demonstrated to reduce the incidence of hypoxia and improve patient safety in multiple studies under various clinical airway management under sedation/anesthesia 8 , 9 . Unlike transtracheal jet ventilation (TTJV), no barotraumas or sever complications during or after the use of SJOV with WNJ have been reported up to now, although some minor adverse events such as pharyngalgia/xerostomia seems and slight epistaxis 8 , 14 , 15 , 18 , 19 (add references that TTJV cause barotrauma) Notably, pharyngalgia/xerostomia seems to be the most common side effects, with an incidence of about 10–20% 8 , 14 , 15 . However, the risk factors for these side effects with SJOV have not been thoroughly evaluated.…”

A new device for monitoring end-tidal carbon dioxide during light sedation in surgical procedures

“… 9 Wei's cannula, which has been scientifically validated mainly in the procedure of bronchoscopy carried out in sedation, has been proved to be an effective device for managing oxygenation of the patient subjected to moderate sedation. 8 The Deaflux (DEAS Co., Castelbolognese, RA, Italy) cannula, evaluated in this report, is different from the Wei cannula. It is equipped with a central lumen (operative/ventilation), another lumen in the cannula wall dedicated to the instillation of drugs, and a rotating hake positioned at the nostril of the patient to detect EtCO 2 .…”

“…Recently, several devices have been developed to evaluate EtCO 2 during sedation. One of these is the Wei cannula, 8 a device equipped with an operating lumen and a lumen dedicated to jet-ventilation through which it is also possible to measure the ETCO 2 . 9 Wei's cannula, which has been scientifically validated mainly in the procedure of bronchoscopy carried out in sedation, has been proved to be an effective device for managing oxygenation of the patient subjected to moderate sedation.…”