Strashnov VI, Pluzhnikov MS, Kolotilov LV, Gir EE, Ouchvatkina MK. High-frequency jet ventilation in endolaryngeal surgery.
J Clin Anesth 1995;
7:19-25. [PMID:
7772353 DOI:
10.1016/0952-8180(94)00009-s]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
STUDY OBJECTIVE
To describe the clinical experience with high-frequency jet ventilation (HFJV) of the lungs during endolaryngeal surgery and its effect on acid-base balance and capillary PO2 (PcO2), PCO2, central hemodynamics, and tracheobronchial mucous membrane.
DESIGN
Evaluation of different modalities of HFJV.
SETTING
Operating rooms and otolaryngology intensive care unit in a medical institute.
PATIENTS
218 patients undergoing elective endolaryngeal surgery.
INTERVENTIONS
Patients receive HFJV through catheters with an inner diameter of 1.4 to 1.8 mm. Catheters were introduced orotracheally, nasotracheally, percutaneously, or through a fenestrated tracheostomy tube. Minute volume was based on body weight times 0.2, corrected for acid-base balance.
MEASUREMENTS AND MAIN RESULTS
Intraoperative cardiac output, airway pressure, changes in tracheobronchial mucosa, and acid-base balance were monitored. HFJV changed central hemodynamics slightly and preserved gas exchange: PcCO2 remained within normal limits, while PcO2 increased. Use of thin catheters enhanced largyneal exposure and surgical manipulation. Percutaneous catheterization permitted resumption of HFJV in the event of laryngeal edema and inadequate spontaneous respiration after surgery.
CONCLUSION
HFJV leads to optimal conditions for endolaryngeal surgery, reverses constant outflow of the respiratory gas mixture, prevents aspiration of tissue products and blood, and removes smoke from the operative site when using laser surgery.
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