The Utility of Routine Chest Radiography Following Jet Ventilation in Elective Laryngotracheal Surgery

Meratı, Albert L.; Sale, Keith A.; Toohill, Robert J.

doi:10.1097/00005537-200408000-00015

“…zur Atelektasenbildung [1]. Merati et al [18] konnten in einer retrospektiven Untersuchung bei ca. 41% der Patienten, die sich einer Mikrolaryngoskopie mit supraglottischer HFJV unterzogen, rönt-genologisch Atelektasen nachweisen.…”

Section: Hypoventilationunclassified

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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“…zur Atelektasenbildung [1]. Merati et al [18] konnten in einer retrospektiven Untersuchung bei ca. 41% der Patienten, die sich einer Mikrolaryngoskopie mit supraglottischer HFJV unterzogen, röntgenologisch Atelektasen nachweisen.…”

Section: Hypoventilationunclassified

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.

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