This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (8)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Eva Lanzenberger-Schragl, MD; Andrew Donner, MD; Matthaeus C. Grasl, MD; Michael Zimpfer, MD; Alexander Aloy, MD

Arch Otolaryngol Head Neck Surg. 2000;126:40-44.

Objective  To describe our experience with superimposed high-frequency jet ventilation (SHFJV), which does not require any endotracheal tubes or catheters, for performing laryngeal and tracheal surgery.

Design  A case series of 500 patients.

Setting  A university medical center.

Patients  Four hundred sixty adult patients and 40 children in a consecutive sample who required laryngeal or tracheal surgery under SHFJV.

Interventions  The SHFJV uses 2 jet streams with different frequencies simultaneously and is applied using a jet laryngoscope. Ventilation was performed with an air-oxygen mixture, and intravenous agents were used for anesthesia. Arterial blood gas values were analyzed.

Main Outcome Measures  Reported values of oxygenation and ventilation during the application of SHFJV and laryngotracheal surgery.

Results  In 497 patients, adequate oxygenation with a mean±SD PaO₂ of 91.8±22.9 mm Hg and ventilation with a PaCO₂ of 29.7±5.5 mm Hg were achieved using SHFJV. The average duration of the application of ventilation was 27 minutes, and the longest duration was 118 minutes. No complications due to the ventilation technique were observed. Laser surgery was performed in 150 patients.

Conclusions  The use of SHFJV in combination with the jet laryngoscope provides patients with sufficient ventilation during laryngotracheal surgery. Even in patients at high risk because of pulmonary or cardiac disease, this technique can be applied safely. In patients with stenosis, the ventilation is applied from above the stenosis, reducing the risk of barotrauma. The SHFJV can be used for tracheobronchial stent insertion, and laser can be used without any additional protective measures.

From the Departments of Anesthesia and General Intensive Care Medicine (Drs Lanzenberger-Schragl, Donner, Zimpfer, and Aloy) and Otorhinolaryngology–Head & Neck Surgery (Dr Grasl), University of Vienna, Vienna, Austria.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Appropriate Ventilatory Settings for Thoracic Surgery: Intraoperative and Postoperative
Lytle and Brown
SEMIN CARDIOTHORAC VASC ANESTH 2008;12:97-108.
ABSTRACT  

Superimposed high-frequency jet ventilation (SHFJV) for endoscopic laryngotracheal surgery in more than 1500 patients
Rezaie-Majd et al.
Br J Anaesth 2006;96:650-659.
ABSTRACT | FULL TEXT  

Comparing Methods of Administering High-Frequency Jet Ventilation in a Model of Laryngotracheal Stenosis
Ng et al.
Anesth. Analg. 2002;95:764-769.
ABSTRACT | FULL TEXT