High-Frequency Jet Ventilation

Klain, Miroslav; Keszler, H

doi:10.1016/s0039-6109(16)43687-x

“…Dabei spielt das klinische Monitoring, wie Beobachten der Thoraxbewegungen und der Auskultationsbefund, eine ganz entscheidende Rolle [14]. …”

Section: Monitoringunclassified

“…Zu den barotraumabedingten Schäden zählen der Pneumothorax, das subkutane Emphysem, das Pneumomediastinum und das Pneumoperitoneum [14]. Das Risiko eines Barotraumas wird bei der infraglottischen bzw.…”

Section: Barotraumaunclassified

“…Bedingt durch die Applikation von nichtklimatisierten Gasvolumina in den Körperkern des Patienten kann es zur relevanten Hypothermie und postoperativ zum Shivering kommen [5,14]. Daher muss die Überwachung der Körpertemperatur standardmäßig durchgeführt und entsprechende Maßnah-men für den Wärmeerhalt des Patienten ergriffen werden.…”

Section: Hypothermieunclassified

“…Nach Ausspannen des Kleinsasser-Instruments durch den Operateur sollte ein suffizienter Gasabstrom durch einen Guedel-, Wendl-Tubus oder das Anwenden des Esmarch-Handgriffs gewährleistet werden [9]. Aufgrund des geringen Durchmessers und des fehlenden Cuff wird der Jetkatheter meist hervorragend toleriert, sodass der aus der Anästhesie erwachende Patient ungestört neben der HFJV spontan atmen kann [4,14]. Bei suffizienter Spontanatmung und Rückkehr der Schutzreflexe wird der Katheter schließlich entfernt.…”

Section: Narkoseführung Am Beispiel Der Infraglottischen Hochfrequenzunclassified

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Anästhesiologische Besonderheiten bei der laryngotrachealen Chirurgie

2011

HNO

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During surgical procedures of the upper respiratory tract anesthesiologists and surgeons are in a kind of competition situation because of the close spatial relationship between the airway of the patient and the surgical area. Especially in laryngeal surgery the use of high-frequency jet ventilation (HFJV) offers an alternative to the endotracheal tube. During HFJV the ventilation gas is intermittently administered by an injector with a high frequency into the airway which is open to the outside. Exhalation occurs passively in the area nearby the wall of the airway cross-section. According to the availability of the technique and the indications jet ventilation can be implemented in an infraglottic, supraglottic, transtracheal or transluminal manner. To exert influence on gas exchange of the patient the respiratory rate, driving pressure, oxygen concentration and inspiration time can be changed according to the needs. Severe tracheal stenosis, risk of excessive bleeding during the procedure, patients at risk for aspiration and exacerbation of lung diseases are depicted as contraindications for HFJV. Complications under HFJV are rare despite the limited conditions for monitoring gas exchange and mechanics of ventilation in contrast to conventional ventilation. A particular challenge for the anesthesiologist is the use of HFJV during laryngeal laser surgery.

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“…Barth [6]. Diese Technik wurde Mitte der 1980er Jahre von Klain weiterentwickelt und somit die HFJV eingeführt [14,23].…”

Section: Geschichtliche Aspekteunclassified

Anästhesiologische Besonderheiten bei der laryngotrachealen Chirurgie

Fritzsche

¹

,

Osmers

²

2010

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During surgical procedures of the upper respiratory tract anesthesiologists and surgeons are in a kind of competition situation because of the close spatial relationship between the airway of the patient and the surgical area. Especially in laryngeal surgery the use of high-frequency jet ventilation (HFJV) offers an alternative to the endotracheal tube. During HFJV the ventilation gas is intermittently administered by an injector with a high frequency into the airway which is open to the outside. Exhalation occurs passively in the area nearby the wall of the airway cross-section. According to the availability of the technique and the indications jet ventilation can be implemented in an infraglottic, supraglottic, transtracheal or transluminal manner. To exert influence on gas exchange of the patient the respiratory rate, driving pressure, oxygen concentration and inspiration time can be changed according to the needs. Severe tracheal stenosis, risk of excessive bleeding during the procedure, patients at risk for aspiration and exacerbation of lung diseases are depicted as contraindications for HFJV. Complications under HFJV are rare despite the limited conditions for monitoring gas exchange and mechanics of ventilation in contrast to conventional ventilation. A particular challenge for the anesthesiologist is the use of HFJV during laryngeal laser surgery.

show abstract