High-frequency Jet Ventilation for Laryngoscopy

Babinski, Maciej; Smith, Randall B.; Klain, Miroslav

doi:10.1097/00000542-198002000-00019

Cited by 63 publications

(18 citation statements)

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“…Various methods of jet ventilation for microlaryngeal surgery have been described in the literature ( 3‐7,12,13 ). These published methods are limited owing to reduced visibility, insufficient CO 2 elimination, danger in the use of the laser, or barotrauma.…”

Section: Discussionmentioning

confidence: 99%

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Tubeless Laryngotracheal Surgery in Infants and Children via Jet Ventilation Laryngoscope

Grasl¹,

Donner²,

Schragl³

et al. 1997

The Laryngoscope

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We present the first use of tubeless superimposed combined high- and low-frequency jet ventilation (SHFJV) with a jet laryngoscope in laryngotracheal surgery in infants and children. Twenty-eight patients underwent 53 operative procedures. The average age of the patients was 7.3 years. The most common diagnoses were laryngeal papillomatosis and subglottic stenosis. The duration of jet ventilation averaged 33 min. The gas exchange was sufficient in each case. The advantages of SHFJV in the surgery of the laryngotracheal area in infants and children are optimal view at the larynx and trachea, maximum space for the handling, application of the laser without risks, no time limitation, suitability for stenosis, and neither anesthetic nor surgical complications.

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Section: Discussionmentioning

confidence: 99%

“…The jet ventilation techniques applied in the past used a single frequency jet stream. The gas was supplied via a small tube, catheter, or a cannula that was inserted into the lumen of the rigid endoscopy tube ( 3‐7 ). SHFJV uses both a low‐frequency and a high‐frequency jet stream, which are superimposed.…”

Section: Introductionmentioning

confidence: 99%

Tubeless Laryngotracheal Surgery in Infants and Children via Jet Ventilation Laryngoscope

Grasl¹,

Donner²,

Schragl³

et al. 1997

The Laryngoscope

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“…This technique is routinely used in our district teaching hospital for laryngology procedures in adults and children (11–13); consequently, operating room personnel have familiarity with the technique. Paediatric scoliosis surgery may often be performed with no special techniques for lung isolation or ventilation; the lung can be retracted during surgery.…”

Section: Discussionmentioning

confidence: 99%

Jet ventilation for anterior paediatric scoliosis surgery

Hübner

Anderson

Stuart

et al. 2002

Pediatric Anesthesia

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Single-lung anaesthesia for thoracotomy is usually achieved with endobronchial intubation, a double-lumen tube or an endobronchial blocker. High-frequency jet ventilation (HFJV) is seldom described for thoracotomy in children, although it is used for both laryngology procedures in the operating room and as a ventilation mode in intensive care. HFJV was used in three children, aged 10-12 years, who presented for scoliosis correction involving thoracotomy. The jet ventilation catheter was passed through a tracheal tube to reduce the risk of outflow obstruction and allow a smooth conversion to intermittent positive-pressure ventilation when required. Mean airway pressures measured at the tip of the HFJV catheter were at or below 4 cmH2O. Surgical opening of the nondependent lung pleura resulted in sufficient collapse of the pulmonary parenchyma with the patient in the lateral decubitus position for the surgical procedure. Arterial blood gas analyses performed during thoracotomy were within normal limits, with no CO2 retention. HFJV is an alternative ventilation strategy for thoracotomy in children because of its unique ability to deliver small tidal volumes at low mean airway pressures via a narrow catheter.

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“…High-frequency ventilation has been used successfully in many surgical proce-. dures, including laryngoscopy [5,15], bronchoscopy [5,9], tracheal reconstruction [69], and open-heart surgery [70]. The ability to ventilate through a small cannula, as in HFJV, makes this technique especially advantageous when both surgeon and anesthesiologist must have airway access.…”

Section: Clinical Applicationsmentioning

confidence: 99%

High-Frequency Ventilation in Newborn Infants

Boynton

Buckley

Frantz

1986

J Intensive Care Med

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In the past mechanical ventilation always mimicked the tidal volumes and ventilatory frequencies of normal breathing. Recently, there has been great interest in techniques that use rapid rates (60 to 3,000 per minute) and tidal volumes approximating dead space. These techniques are known collectively as high-frequency ventilation, although they differ in circuit design, use, potential complications, and mechanism of gas transport. High-frequency ventilation can be divided into four categories: (1) high-frequency positive pressure ventilation, (2) high-frequency jet ventilation, (3) highfrequency oscillatory ventilation and high-frequency flow interruption, and (4) high-frequency chest wall oscillation. In this review we discuss the similarities and differences of these high-frequency techniques, their clinical applications, and some physiological mechanisms involved in gas transport. High-Frequency Positive Pressure VentilationHigh-frequency positive pressure ventilation (HFPPV) was discovered by Sj6strand and coworkers [1] while searching for a method of mechanical ventilation that would not cause respiratory synchronous variations in blood pressure. Their original,system consisted of a small catheter placed in the lumen of an endotracheal tube through which compressed gas was delivered at frequencies of 60 to 100 per minute. This system proved impractical for clinical use, and a new ventilator was developed with low internal compliance and high driving pressure. Pulses of compressed gas entered the endotracheal tube through a side arm that functioned as a pneumatic valve [1] ] (Table).Standard mechanical ventilators have also been used for HFPPV [2]. The tidal volumes delivered during HFPPV vary among ventilators. Frantz [3], among others, has hypothesized that the tidal volume almost always exceeds dead space, whereas others [4,48] have reported tidal volumes as low as 3 ml/kg body weight. HFPPV is used frequently during bronchoscopy and tracheal surgery because it allows full airway access [5]. It has also been used to ventilate patients with adult respiratory distress syndrome because it helps mobilize secretions and decreases the need for sedation [6]. In the few studies on the use of HFPPV in neonates, HFPPV has been shown to maintain adequate gas exchange at low peak airway pressures [7]. Rates of 60 to 150 breaths per minute are often used in infants who are hypoxic or hypercapnic despite appropriate conventional ventilation. Rates of 120 to 150 per minute can be delivered by manual ventilation with an anesthesia bag or by conventional neonatal venat UNIVERSITE DE MONTREAL on June 14, 2015 jic.sagepub.com Downloaded from

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High-frequency Jet Ventilation for Laryngoscopy

Cited by 63 publications

References 0 publications

Tubeless Laryngotracheal Surgery in Infants and Children via Jet Ventilation Laryngoscope

Tubeless Laryngotracheal Surgery in Infants and Children via Jet Ventilation Laryngoscope

Jet ventilation for anterior paediatric scoliosis surgery

High-Frequency Ventilation in Newborn Infants

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