High frequency jet ventilation through a supraglottic airway device: a case series of patients undergoing extra‐corporeal shock wave lithotripsy

Canty, D. J.; Dhara, S. S.

doi:10.1111/j.1365-2044.2009.06079.x

Cited by 10 publications

(6 citation statements)

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“…As expected, HFJV-assisted cases demonstrated significantly lower diaphragmatic excursion compared to IPPV (mean 1.3 mm, compared with 20 mm for IPPV), and similar results (1.3 mm excursion with HFJV assistance compared with 11 mm for IPPV) were observed intraprocedurally in the five cases with HFJV assistance, although did not reach statistical significance likely due to small sample size. These measurements are comparable with reported excursion of 1–3 cm during quiet breathing and conventional IPPV [29, 30] and with prior studies reporting reduced diaphragmatic motion during HFJV-assisted extracorporeal shockwave lithotripsy [25].…”

Section: Discussionsupporting

confidence: 89%

“…The HFJV is a mechanical ventilation method initially described in 1977 by Klain and Smith [28], in which small tidal volumes of pressurised gas are delivered through a narrow-bore endotracheal catheter at very high respiratory rates. The technique facilitates adequate gas exchange while minimising diaphragmatic excursion, and thoracoabdominal target lesions normally subject to significant respiratory positional variation are rendered relatively motionless [14, 15, 25]. Several recent interventional radiology reports have demonstrated improved lesion targeting, reduced technical difficulty and procedural time, and reduced patient radiation dose during thermal ablation of lung, liver, and renal tumours [19–24].…”

Section: Discussionmentioning

confidence: 99%

“…High-frequency jet ventilation (HFJV) utilises limited tidal volumes (1–3 mL/kg, often less than dead space) at high frequencies (> 100 cycles/min) to minimise thoracoabdominal motion compared with IPPV [14, 15]. The technique has been applied to thoracic surgery, extracorporeal shockwave lithotripsy, cardiac ablation, and percutaneous tumour ablation procedures to reduce target-lesion motion and optimise therapy [14, 16–25]. To our knowledge, there are no prior studies evaluating potential benefits in endovascular embolisation procedures.…”

Section: Introductionmentioning

confidence: 99%

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Embolisation of pulmonary arteriovenous malformations using high-frequency jet ventilation: benefits of minimising respiratory motion

et al. 2019

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Background To evaluate patient radiation dose and procedural duration recorded during pulmonary arteriovenous malformation (PAVM) embolisation performed using high-frequency jet ventilation (HFJV) as compared with conventional intermittent positive pressure ventilation (IPPV) Methods Patients undergoing PAVM embolisation with HFJV assistance after April 2017 were retrospectively identified as group A, and those treated with IPPV before April 2017 as group B. Primary outcomes were patient radiation dose and procedural duration between groups A and B. Secondary outcomes were difference in diaphragmatic excursion between groups A and B, in group A with/without HFJ assistance, technical/clinical success, and complications. Results Twelve PAVMs were embolised in 5 patients from group A, and 15 PAVMs in 10 patients from group B. Mean patient radiation was significantly lower in group A than in group B (54,307 ± 33,823 mGy cm 2 [mean ± standard deviation] versus 100,704 ± 43,930 mGy cm 2 ; p = 0.022). Procedural duration was 33.4 ± 16.1 min in group A versus 57.4 ± 14.9 min in group B ( p = 0.062). Diaphragmatic excursion was significantly lower in group A (1.3 ± 0.4 mm) than in group B (19.7 ± 5.2 mm; p < 0.001) and lower with near statistical significance in group A with HFJV than without HFJV (1.3 ± 0.4 mm versus 10.9 ± 3.1 mm; p = 0.062). Technical and clinical success was 100% in both groups, without relevant complications. Conclusion HFJV-assisted PAVM embolisation is a safe, feasible technique resulting in reduced patient radiation doses and procedural time.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Embolisation of pulmonary arteriovenous malformations using high-frequency jet ventilation: benefits of minimising respiratory motion

et al. 2019

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“…13 We observed an increase in Etco 2 for some patients but do not routinely measure arterial blood gases. Supraglottic airways can be electively used to deliver HFJV 14 although we do so infrequently. We include 1 case but the provider reported low satisfaction due to needing repeated adjustment of driving pressure.…”

Section: Discussionmentioning

confidence: 99%

In-Circuit High-Frequency Jet Ventilation for Radiological Tumor Ablation: A Case Series

et al. 2022

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High-frequency jet ventilation (HFJV) can reduce organ movement that otherwise complicates percutaneous image-guided ablation (IGA) procedures. This study describes feasibility and safety of the technique in routine use. We describe our method for the use of HFJV and present 169 consecutive cases, including IGA of tumors of the lung, liver, kidney, and pancreas. Intended oncological treatment was delivered in all cases and HFJV used for the duration of treatment in all except one case. We describe the characteristics of patients, procedures, and adverse events. It is feasible to use HFJV as the routine standard of care for IGA.

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“…In the field of percutaneous ablation, the only series we found in literature was a retrospective observational study published in 2011 in which nine patients with hepatic or renal lesions were treated under HFJV [4]. We have also acknowledged several reports associating high frequency jet ventilation with extracorporeal shock wave lithotripsy [5][6][7], a technique similar to some extent to HIFU. It was shown that HFJV reduced urinary stone movement, which increased lithotripsy efficiency with better utilization of shockwave energy and less patient exposure to tissue trauma.…”

Section: Dear Editormentioning

confidence: 99%

Reply to: High-Frequency Jet Ventilation for HIFU

Muller

Petrusca

Auboiroux

et al. 2014

Cardiovasc Intervent Radiol

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We would like to thank Dr. Denys for his insightful comments and to the Editorial Board of this Journal for offering us the opportunity to communicate a reply letter. We aim here to evaluate, comprehensively and concisely, what we believe to be essential issues concerning the use of HFJV as a motion suppression technique for abdominal ablation during extracorporeal HIFU.At the time we made the final submission of our review article [1], Denys et al. article [2] had not yet been publicly released. Moreover, no clinical experience describing the association of HIFU and HFJV techniques had been published and to the best of our knowledge, this continues to be the situation today. The reports we have cited consider the application of HFJV to radiation therapy, percutaneous thermal ablation, or extracorporeal shock wave lithotripsy. To summarize, Fritz et al. [3], working with radiotherapy, showed that HFJV enabled liver motion to be minimized to 3 mm, in agreement with Denys et al. experience. In the field of percutaneous ablation, the only series we found in literature was a retrospective observational study published in 2011 in which nine patients with hepatic or renal lesions were treated under HFJV [4]. We have also acknowledged several reports associating high frequency jet ventilation with extracorporeal shock wave lithotripsy [5-7], a technique similar to some extent to HIFU. It was shown that HFJV reduced urinary stone movement, which increased lithotripsy efficiency with better utilization of shockwave energy and less patient exposure to tissue trauma.Denys et al. study is the first prospective study for percutaneous thermal ablation with the inclusion of a large subset of patients with an intention to treat with HFJV. A real estimation of the proportion of patients noneligible for HFJV therefore can be calculated and details of the exclusion criteria are provided. Overall, their report provides detailed informations on HFJV applied to thermotherapy while we have only summarized some principles in our referenced article whose aim was to review broader topics.We agree with the observation that some lesions located in the upper part of the liver may not be treatable with extracorporeal HIFU under HFJV due to patient being ventilated in a position near of end expiration. This is a problem we have already been confronted with during conventional mechanical ventilation, since we performed sonication during the expiration phase (in sheep and pig animal studies), as it is the longest and most stable phase. Interestingly, intercostal sonication was demonstrated to be feasible [8]; however, the interposition of the right lung's inferior lobe in the HIFU beam may be a complicated problem for this configuration.Dr. Denys and his team mentioned the possibility of using HFJV for a long period of time. In the specific

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High frequency jet ventilation through a supraglottic airway device: a case series of patients undergoing extra‐corporeal shock wave lithotripsy

Cited by 10 publications

References 10 publications

Embolisation of pulmonary arteriovenous malformations using high-frequency jet ventilation: benefits of minimising respiratory motion

Embolisation of pulmonary arteriovenous malformations using high-frequency jet ventilation: benefits of minimising respiratory motion

In-Circuit High-Frequency Jet Ventilation for Radiological Tumor Ablation: A Case Series

Reply to: High-Frequency Jet Ventilation for HIFU

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