The use of high-frequency ventilation during general anaesthesia: an update

Galmén, Karolina; Harbut, Piotr; Freedman, Jacob; Jakobsson, Jan

doi:10.12688/f1000research.10823.1

Cited by 31 publications

(26 citation statements)

References 24 publications

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“…This can happen with normal respiration where the liver can be displaced with up to 30 mm with each breath. The solution to this problem was the use of high-frequency jet ventilation where respiratory movement of abdominal organs are minimized to 2–3 mm [8,9]. Other sources of organ displacement over time is the formation of lung atelectases, pneumothorax or bleeding under the liver capsule when targeting more than one tumour, oedema around larger ablated tumours and also varying muscular relaxation levels during the course of the anaesthesia.…”

Section: Resultsmentioning

confidence: 99%

1000 consecutive ablation sessions in the era of computer assisted image guidance – Lessons learned

Beermann

Lindeberg

Engstrand

et al. 2019

European Journal of Radiology Open

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HighlightsComputer assisted targeting techniques are simple to use and improve results in ablative tumour treatments.The indications for ablative soft tissue tumour ablation are increasing.Treatments are superior to resective surgery in terms of complications and hospitalization, oncological non-inferiority remains to be proven.An incomplete ablation can be retreated without negative effects on survival.Jet ventilation is an effective technique to minimize organ displacement during percutaneous or laparoscopic ablation.

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Section: Resultsmentioning

confidence: 99%

1000 consecutive ablation sessions in the era of computer assisted image guidance – Lessons learned

Beermann

Lindeberg

Engstrand

et al. 2019

European Journal of Radiology Open

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“…HFJV became a technique to maintain ventilation since Klain and Smith developed it 5,6 . Gas enters the breathing path at low pressure through a narrow jet tube.…”

Section: Discussionmentioning

confidence: 99%

High frequency jet ventilation through mask contribute to oxygen therapy in patients undergoing bronchoscopic intervention under deep sedation

Yang

Wang

Hou

et al. 2020

Preprint

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Background: High frequency jet ventilation (HFJV) is an open ventilating technique to maintain ventilation for emergency or difficult airway. However, it is unclear whether jet ventilation or conventional oxygen therapy (COT) is more effectively and safely to maintain adequate oxygenation in patients with airway stenosis during bronchoscopic intervention (BI) under deep sedation.Methods: A prospective randomized cohort study was conducted to compare HFJV with normal frequency jet ventilation (NFJV) and COT (high flow oxygen) in oxygen supplementation during BI under deep sedation from March 2020 to August 2020. Patients receiving BI under deep sedation were randomly divided into 3 parallel groups of 50 patients each: the COT group (FiO21.0, 12 L/min), the NFJV Group (FiO2 1.0, driving pressure 0.1MPa, respiratory rate (RR) 15bpm) and HFJV Group (FiO2 1.0, driving pressure 0.1MPa, RR 1200bpm). SpO2, MBP and HR were recorded during the whole procedure. Arterial blood gas was examined and recorded at 15 minutes after initiation of procedure. Procedure duration, dose of anesthetics and adverse events during BI in the three groups were also recorded.Results: A total of 161 patients were enrolled with 11 patients excluded. Clinical characteristics were similar among the three groups. PaO2 of HFJV group was significantly higher than that of COT and NFJV group (P<0.001). PaO2 was significantly correlated with ventilation mode (P<0.001), BMI (P=0.019) and procedure duration (P=0.001). Multiple linear regression showed that only BMI and procedure duration were independent influencing factors of arterial blood gas PaO2 (P=0.040, P=0.002). The location of airway lesions and severity of airway stenosis were no statistical correlation with PaCO2 and PaO2.Conclusions: HFJV can effectively and safely improve intra-operative PaO2 in patients with airway stenosis during BI in deep sedation, and doesn’t increase intra-operative PaCO2 and the risk of hypercapnia. The location of airway lesions and severity of airway stenosis may not affect oxygenation maintain during basic and some advanced BI.Trial registration: Chinese Clinical Trial Registry. Registration number, ChiCTR2000031110, registered on March 22, 2020.

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“…Öberg and Sjöstrand were first to describe the HFJV in 1967 [9]. Initially it was utilized in otolaryngology, bronchial and lung surgery [12]. In the past decade, an increasing interest in HFJV’s advantages in keeping target organs relatively motionless during surgery to optimize surgical precision has grown.…”

Section: Discussionmentioning

confidence: 99%

Reducing kidney motion: optimizing anesthesia and combining respiratory support for retrograde intrarenal surgery: a pilot study

et al. 2019

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Background One of the greatest challenges presented with RIRS is the potential for movement of the stone within the operative field associated with diaphragm and chest respiratory excursions due to mechanical ventilation. To overcome this challenge, we propose in this pilot study a new general anesthesia technique combining high frequency jet ventilation (HFJV) with small volume mechanical ventilation (SVMV). Data regarding safety, feasibility and surgeons’ impression was assessed. Methods Patients undergoing RIRS for kidney stones from November 2017 to May 2018 were prospectively recruited to participate in the study. In each case after the beginning of general anesthesia (GA) with mechanical ventilation (MV) surgeons were asked to assess the mobility of the operative field and conditions for laser lithotripsy according to the developed questionnaire scale. The questionnaire consisted of 5 degrees of assessment of kidney mobility and each question was scored from 1 to 5, 1 being very mobile (extremely poor conditions for dusting) and 5 completely immobile (Ideal conditions for dusting). After the assessment GA was modified with combined respiratory support (CRS), reducing tidal volume and respiratory rate (small volume mechanical ventilation, SVMV) and applying in the same time transcatheter high frequency jet ventilation (HFJV) inside the closed circuit. After beginning of CRS, surgeons were once again asked to assess the mobility of the operative field and the conditions for laser lithotripsy. Main ventilation parameters were recorded and compared in both regimens. Results A total of 38 patients were included in the study. The mean age was 49 (range 45–53) with a mean stone size of 10 mm (range 10–14) and Hounsfield unit of 1060 (range 930–1190). All patients underwent successful RIRS and no intraoperative complications occurred throughout the duration of the study. A statistically significant difference between ventilation parameters prior to and after CRS institution was detected in all cases, however their clinical impact was negligible. Despite this, assessment via the questionnaire scale point values varied significantly before and after the application of CRS and were 2.3 (2.1; 2.6) and 3.8 (3.7; 4.0) respectively ( p < 0.001). Conclusions The novel combined respiratory approach consisting of HFJV and SVMV appears to provide better conditions for stone dusting through reduced respiratory kidney motion and is not associated with adverse health effects or complications. Trial registration NCT03999255 , date of registration: 25th June 2019 (retrospectively registered).

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The use of high-frequency ventilation during general anaesthesia: an update

Cited by 31 publications

References 24 publications

1000 consecutive ablation sessions in the era of computer assisted image guidance – Lessons learned

1000 consecutive ablation sessions in the era of computer assisted image guidance – Lessons learned

High frequency jet ventilation through mask contribute to oxygen therapy in patients undergoing bronchoscopic intervention under deep sedation

Reducing kidney motion: optimizing anesthesia and combining respiratory support for retrograde intrarenal surgery: a pilot study

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