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Revista Cubana de Anestesiología y Reanimación

ISSN 1726-6718 (Electronic)
Revista Cubana de Anestesiología y Reanimación
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2018, Number 2

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Revista Cubana de Anestesiología y Reanimación 2018; 17 (2)

Safety and effectiveness of jet ventilation with conventional ventilatory frequencies for elective microlaryngeal surgery

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Language: Spanish
References: 17
Page: 1-11
PDF size: 234.73 Kb.


Key words:

jet ventilation, tracheal intubation, microlaryngeal surgery, difficult airway, cricothyroidotomy.

ABSTRACT

Introduction: Ventilation to the patient during microlaryngeal surgery confronts several problems. Jet ventilation with conventional ventilatory frequencies allows the use of small diameter endotracheal catheters to provide adequate oxygen volumes and provide better operating conditions than the traditional method.
Objective: To evaluate the safety and effectiveness of jet ventilation with conventional ventilatory frequencies for elective microlaryngeal surgery in comparison to conventional ventilation.
Methods: A comparative, single-blind, randomized and parallel study was performed. It was used a prototype of jet ventilation device with an exceptional use permit in humans (exceptional authorization No: 004/17 for conducting a pilot study, dated August 2, 2017, conferred by the CECMED). A study group of 45 patients (group E) was used and compared with a control group (group C) of 15 patients using the traditional ventilation method.
Results: Oxygenation was higher in group E. Group C eventually required extubation, transitory apnea and reintubation, which impacted against the anatomophysiological integrity of patients, the operative field and teaching. A greater hemodynamic stability was evident among the subjects of group E. The intrapulmonary pressures produced by jet ventilation did not cause obvious injuries or clinical repercussions.
Conclusions: Applying jet ventilation with conventional ventilatory frequencies was safe and effective. For the first time, experiences of using a jet ventilation method in the country were obtained. The group in which conventional ventilation was applied suffered more frequent and dangerous complications. It is necessary to assimilate jet ventilation´s technologies to raise the quality of medical attention in times of peace, war or disasters, in elective or emerging contexts as the challenge of a difficult airway.


REFERENCES

  1. Glenski JA, MacKenzie RA, Maragos NE, Southora PA. Assessing tidal volume and detecting hyperinflation during venturi jet ventilation for microlaryngeal surgery. Anesthesiology. 1985;63:554-5.

  2. Atkins JH, Mirza N, Mandel JE. Case report: respiratory inductance plethysmography as a monitor of ventilation during laser ablation and balloon dilatation of subglottic tracheal stenosis. ORL J. 2009;71(5):289-91.

  3. Benumof JL. Management of the difficult adult airway. Anesthesiology. 1991(75):1087-110.

  4. Atkins JH, Mandel JE, Weinstein GS, Mirza N. A pilot study of respiratory inductance plethysmography as a safe, noninvasive detector of jet ventilation under general anesthesia. Anesth Analg. 2010;111(5):1168-75.

  5. Nicelli E, Gemma M, De Vitis A, Foti G, Beretta L. Feasibility of standard mechanical ventilation with low FiO2 and small endotracheal tubes during laser microlaryngeal surgery. Head Neck. 2010;32(2):204-9.

  6. Abad HL, Ajalloueyan M, Jalali AR. Impact of body mass index (BMI) on ventilation during low-frequency jet ventilation. Otolaryngol Head Neck Surg. 2007;136(3):477- 80.

  7. Bourgain JL, McGee K, Cosset MF, Bromley L, Meistelman C. Carbon dioxide monitoring during high frequency jet ventilation for direct laryngoscopy. Br J Anaesth. 1990;64(3):327-30.

  8. Ahmed-Nusrath A, Nusrath MA, Bryant D. Precautions required for needle cricothyroidotomy. Br J Oral Maxillofac Surg. 2010;48(5):396-7.

  9. Williams A, Patel A, Ferguson C. High frequency jet ventilation through the laryngeal mask airway in a critically obstructed airway. Anaesthesia. 2008;63(12):1369-71.

  10. Bourgain JL, Chollet M, Fischler M, Gueret G, Mayne A. Guide for the use of jetventilation during ENT and oral surgery. Ann Fr Anesth Reanim. 2010;29(10):720-7.

  11. Hunsaker DH. Anesthesia for microlaryngeal surgery: the case for subglottic jet ventilation. Laryngoscope. 1994;104(65):1-30.

  12. Biro P. Jet ventilation for surgical interventions in the upper airway. Anesthesiol Clin. 2010;28(3):397-409.

  13. Gilbey P, Kukuev Y, Samet A, Talmon Y, Ivry S. The quality of the surgical field during functional endoscopic sinus surgery -the effect of the mode of ventilation- a randomized, prospective, double-blind study. Laryngoscope. 2009;119(12):2449-53.

  14. Buise M, van Bommel J, van Genderen M, Tilanus H, van Zundert A, Gommers D. Two-lung high-frequency jet ventilation as an alternative ventilation technique during transthoracic esophagectomy. J Cardiothorac Vasc Anesth. 2009;23(4):509-12.

  15. Smirnov AE, Klochikhin AL. Maintenance of respiratory function during direct laryngoscopy in patients with laryngeal neoplasms. Vestn Otorinolaringol. 2010;(1):33-7.

  16. Anuario Estadístico de Salud 2010 de Cuba. MINSAP. Dirección Nacional de Registros Médicos y Estadísticas de Salud. La Habana; 2011. p. 78-81.

  17. Misiolek H, Knapik P, Swanevelder J, Wyatt R, Misiolek M. Comparison of doublelung jet ventilation and one-lung ventilation for thoracotomy. Eur J Anaesthesiol. 2008;25(1):15-21.




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Revista Cubana de Anestesiología y Reanimación. 2018;17