Superimposed High-Frequency Jet Ventilation for Laryngeal and Tracheal Surgery

Abstract

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 airoxygen 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 PaO 2 of 91.8 ± 22.9 mm Hg and ventilation with a PaCO 2 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.

Airway management and anesthesia in neonates, infants and children during endolaryngotracheal surgery

“…In our study of 62 endolaryngotracheal surgical procedures in neonates, infants and children, we can confirm previous findings, that supraglottic superimposed high‐frequency jet ventilation (SHFJV) via modified jet laryngoscopes with integrated jet nozzles, is a safe and minimally invasive technique in endoscopic airway surgery, especially in infants and children (8–11).…”

Suspension Laryngoscopy for Endotracheal Stenting

“…Jet ventilation has previously been shown to provide patients with safe and reliable ventilation during laryngotracheal interventions. 31 …”

Appropriate Ventilatory Settings for Thoracic Surgery: Intraoperative and Postoperative

“…84 High-frequency jet ventilation (HFJV) has been used for gas exchange during laryngeal and tracheal surgery, bronchoscopy, and during thoracic surgery in the operative lung through a double-lumen tube. [91][92][93] This mode uses small Vt, delivered at high rates, through a narrow tube, cannula, or catheter. 94 Sixty patients undergoing pneumonectomy, lobectomy, or segmentectomy were randomized to receive HFJV through a standard endotracheal tube (n = 29) or OLV via a double-lumen endotracheal tube (n = 31).…”