High-frequency jet ventilation in European and North American institutions: developments and clinical practice

Abstract

Respiratory support with high-frequency jet ventilation has been advocated during airway surgery or to improve pulmonary mechanics and gas exchange in patients with bronchopleural fistulae or pulmonary insufficiency. Despite a large body of published evidence describing its benefits as an alternative ventilatory approach in anaesthesia and intensive care medicine, its application has not gained widespread acceptance and is restricted to specialized centres. To review the literature on high-frequency jet ventilation in European and North American institutions, we performed a search in a computerized database (MEDLINE) covering the period from 1990 until the present time, describing the use of high-frequency jet ventilation in over 7000 patients. Various modes to apply high-frequency jet ventilation during airway surgery have been established, but its value in intensive care is controversial. We report our experience with combined high-frequency jet ventilation and provide guidelines for its safe application.

Supraglottic jet ventilation assists intubation in a Marfan's syndrome patient with a difficult airway

“…The "cannot ventilate-cannot intubate" emergency situation is responsible for 1% to 28% of all deaths associated with anesthesia [5]. Jet ventilation is ideal for providing oxygenation and ventilation during intubation as it may reduce hypoxia-related morbidity and mortality in the management of difficult airways [6]. Needle cricothyrotomy with subsequent transtracheal jet ventilation (TTJV) is one of the recommended final life-saving steps in the "cannot ventilate-cannot intubate" emergency airway algorithm proposed by both the ASA and the Difficult Airway Society [7,8].…”

Entwicklung eines Jet-Tracheoskops Wertigkeit und Einsatzmöglichkeiten der superponierten Hochfrequenz-Jet-Ventilation (SHFJV) in der endoskopischen Chirurgie der Atemwege

“…Die Jet-Ventilation stellt eine mittlerweile etablierte Methode für diagnostische und therapeutische Eingriffe in den Atemwegen dar [7,8,16]. Unsere klinischen Erfahrungen bestätigen die Literaturangaben, denen zufolge die SHFJV eine komplikationsarme und in der Praxis wertvolle Beatmungsmethode für die endolaryngeale und, mit den neuentwickelten Jet-Tracheoskopen (Abb.…”

“…Unsere klinischen Erfahrungen bestätigen die Literaturangaben, denen zufolge die SHFJV eine komplikationsarme und in der Praxis wertvolle Beatmungsmethode für die endolaryngeale und, mit den neuentwickelten Jet-Tracheoskopen (Abb. 1), auch für die endotracheale Chirurgie ist [1,2,3,4,5,13,16,24].…”

Combining transtracheal catheter oxygenation and needle-based Seldinger cricothyrotomy into a single, sequential procedure

“…Despite limited use outside the surgical, anesthesia, and intensive care medicine specialties, a significant amount of literature advocates percutaneous transtracheal jet ventilation (PTJV) as an alternate ventilatory approach for providing rapid oxygenation [6]. Increased utilization of PTJV in conjunction with a Seldinger cricothyrotomy procedure may help expedite and sustain oxygenation in the "can't intubate, can't ventilate" patient.…”