Pressures Available for Transtracheal Jet Ventilation from Anesthesia Machines and Wall-Mounted Oxygen Flowmeters

Fassl, Jens; Jenny, Uta; Nikiforov, S; Murray, W. Bosseau; Foster, Patrick Anthony

doi:10.1213/ane.0b013e3181c22021

Cited by 9 publications

(6 citation statements)

References 14 publications

(16 reference statements)

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“…Another method of oxygen delivery in cannula cricothyroidotomy is a direct connection between the cannula and tube from another oxygen supply. Fassl et al investigated the driving pressure of sources of oxygen, such as wall-mounted oxygen flowmeters and AM auxiliary oxygen flowmeters [ 18 ]. The oxygen flush mechanisms of several kinds of AMs were found to be unable to deliver sufficient flows, as seen in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Doi

Miyashita

Furuya

et al. 2015

BioMed Research International

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A “cannot-ventilate, cannot-intubate” situation is critical. In difficult airway management, transtracheal jet ventilation (TTJV) has been recommended as an invasive procedure, but specialized equipment is required. However, the influence of upper airway resistance (UAR) during TTJV has not been clarified. The aim of this study was to compare TTJV using a manual jet ventilator (MJV) and the oxygen flush device of the anesthetic machine (AM). We made a model lung offering variable UAR by adjustment of tracheal tube size that can ventilate through a 14-G cannula. We measured side flow due to the Venturi effect during TTJV, inspired tidal volume (TVi), and expiratory time under various inspiratory times. No Venturi effect was detected during TTJV with either device. With the MJV, TVi tended to increase in proportion to UAR. With AM, significant variations in TVi was not detected with changes in any UAR. In conclusion, UAR influenced forward flow of TTJV in the model lung. The influence of choked flow from the Venturi effect was minimal under all UAR settings with the MJV, but the AM could not deliver sufficient flow.

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Section: Discussionmentioning

confidence: 99%

“…The oxygen flush mechanisms of several kinds of AMs were found to be unable to deliver sufficient flows, as seen in the present study. They concluded that several flowmeters were acceptable to use as oxygen sources for TTJV in their study [ 18 ], but these methods needed specialized devices to connect the catheter for TTJV.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Doi

Miyashita

Furuya

et al. 2015

BioMed Research International

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“…For example, in the older Dahtex-Ohmeda Aestiva/5 (GE Healthcare, USA) and Dahtex-Ohmeda Anesthesia Delivery Unit, fresh gas decoupling was done through mechanisms that required several breaths to equilibrate, and thus did not immediately protect against sudden increases in flow and pressure during inspiration. 4 As such, it would be dangerous to assume that the oxygen flush valve can always be safely used during inspiration in all machines with fresh gas decoupling in young children.…”

Section: Correspondencementioning

confidence: 99%

“…The oxygen flush valve has also been described for use in jet ventilation should other oxygen sources not be available. 3,4 All modern anesthesia machines provide easy access to an oxygen flush valve because there may be instances in which rapid oxygen delivery is needed.…”

mentioning

confidence: 99%

Iatrogenic Pediatric Pneumothorax: Reply

Pecorella¹,

Smith²,

Smith³

et al. 2022

Anesthesiology

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W e would like to address the concerns raised by Pecorella et al. in their recent "Images in Anesthesiology" publication entitled "Too Much of a Good Thing: Iatrogenic Pediatric Pneumothorax from Engagement of the Oxygen Flush Valve." 1 We agree that if the adjustable pressure-limiting valve is fully closed during manual ventilation and the oxygen flush is engaged, then high pressures can rapidly develop in the circuit, which will then be delivered to the patient. However, it is worth clarifying when it is safe to use the oxygen flush valve-whether in manual or mechanical ventilation mode-even in pediatric patients. The answer CORRES

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confidence: 99%

Iatrogenic Pediatric Pneumothorax: Comment

Xie

Ramamurthi²

2022

Anesthesiology

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Pressures Available for Transtracheal Jet Ventilation from Anesthesia Machines and Wall-Mounted Oxygen Flowmeters

Abstract: Oxygen sources other than dedicated jet ventilator connectors to high-pressure pipeline oxygen may supply adequate working pressure, but each type of oxygen source needs testing to ensure that it supplies adequate working pressure.

Cited by 9 publications

References 14 publications

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

Iatrogenic Pediatric Pneumothorax: Reply

Iatrogenic Pediatric Pneumothorax: Comment

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