Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Doi, Takahiro; Miyashita, Tetsuya; Furuya, Ryosuke; Sato, Hitoshi; Takaki, Satoshi; Goto, Takahisa

doi:10.1155/2015/454807

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Gas is delivered at high pulse rates with low tidal volumes or low pulse rates with larger tidal volumes via rigid cannula that can be associated with a bronchoscope or laryngoscope, via cricothyroidotomy cannula, or introduced into a tracheal tube. Jet ventilation devices can deliver nearly 1 liter per second through a 14 gauge needle at 30 psi (2 atmospheres) and 1.25 liters per second at 50 psi (3.4 atm), and do so for as long as they are active. The main concern is that the continuous use of high driving pressures can easily traumatize the airway or cause pneumothorax …”

Section: Discussionmentioning

confidence: 99%

“…Jet ventilation [19][20][21][22][23][24][25][26] has been used more commonly in cases of upper airway obstruction to increase the time available for intubation. Gas is delivered at high pulse rates with low tidal volumes or low pulse rates with larger tidal volumes via rigid cannula that can be associated with a bronchoscope or laryngoscope, via cricothyroidotomy cannula, or introduced into a tracheal tube.…”

Section: Comparison With Transtracheal Insufflation and Jet Ventilationmentioning

confidence: 99%

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A Resuscitation Option for Upper Airway Occlusion Based on Bolus Transtracheal Lung Inflation

Villiere

Nakase

Kollmar

et al. 2018

Laryngoscope Investig Oto

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BackgroundAcute laryngospasm sufficient to cause obstructive apnea is a medical emergency that can be difficult to manage within the very short time available for establishing an airway. We have presented substantial evidence that laryngospasm‐based obstructive apnea is the cause of sudden death in epilepsy, and airway management is particularly challenging during seizure activity.ObjectiveWe sought to determine if the transtracheal delivery of a bolus of oxygen or room air below the level of an obstruction to inflate the lungs could be an effective method to prolong the time available for responders seeking to establish a stable airway, and, if so, what could be learned about optimization of delivery parameters from a rat model.MethodsRats were fitted with a t‐shaped tracheal tube for controlling access to air and for measuring airway pressures. After respiratory arrest from simulated laryngospasm, bolus transtracheal lung inflation with a volume of gas equivalent to half the vital capacity was delivered to the closed respiratory system as the only resuscitation step.ResultsBolus lung inflation was sufficient for resuscitation, improving cardiac function and re‐establishing adequate oxygen status to support life. Inflation steps could be repeated and survival times were approximately 3 times that of non‐inflated lungs.ConclusionThe properties and consequences of bolus lung inflation are described as a foundation for procedures or devices that can be useful in cases of severe laryngospasm and other cases of upper airway obstruction.Level of Evidence3

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Section: Discussionmentioning

confidence: 99%