Transtracheal jet ventilation in 50 patients with severe airway compromise and stridor

Abstract

We attribute this low incidence to the use of an automated jet ventilator with airway pressure monitoring and control, and the alteration of ventilator parameters by an experienced anaesthetist.

Difficulties in Management of a Sessile Subglottic Polyp

“…If the airway allows a small diameter of endotracheal tube, awake fiberoptic intubation [8] with guidewire can be tried. Methods like Laryngeal mask airway [5], High frequency jet ventilation at supraglottic and infraglottic areas have several advantages [9]. When any of these methods are possible, the definitive removal of lesion can also be done at the same setting.…”

“…Open tracheostomy maintains airway patency, protects the lungs and permits leakfree ventilation [5]. Ross-Anderson and colleagues have proposed Trans tracheal jet ventilation as an alternative in difficult airway management in adult patients with critical airway and monitor with careful use of automated jet ventilator [9].…”

Progress in management of the obstructed airway

“…Opinions differ as some experts propose techniques that other experts find unacceptable and explicitly criticise [1][2][3]. There are advocates of inducing general anaesthesia by an inhalational route and avoiding neuromuscular blockade [4]; of inducing general anaesthesia by the intravenous route and using neuromuscular blockade [5]; of avoiding general anaesthesia altogether and securing an airway by an awake fibreoptic intubation technique [6,7]; of tracheostomy under local anaesthesia [8]; or of insertion of a transtracheal catheter under local anaesthesia [9]. The advocates of these various techniques claim that each respectively provides the best management and the range of choices can appear very confusing for the anaesthetist who is actually faced with a patient who has an obstructed airway.…”

Anaesthetic management of acute airway obstruction

“…(86) RossAnderson et al (86) achieved adequate ventilation in 95% of their patients using this technique, with minor complications occurring in 20%. They used an automated jet ventilator with a pause pressure function, a pre-set airway pressure limit above which the alarms are set off and the ventilator stops jetting, thus minimising the risk of barotrauma.…”