Anest. intenziv. Med. 2018;29(4):187-192

Comparison of catheter high-frequency jet ventilation and conventional ventilation during interventional bronchoscopy in patients with upper airway obstructionOriginal Article

M. Paulíková^1,*, P. Matula²

¹ Oddelenie anestéziológie a intenzívnej medicíny, Východoslovenský onkologický ústav Košice, Slovenská republika

² Klinika rádioterapie a onkológie, Východoslovenský onkologický ústav Košice, Slovenská republika

Objective:
To investigate the risks and safety of catheter high-frequency jet ventilation in laryngeal surgery with varying degrees of airway obstruction.

Design:
Observational, prospective study.


Setting:
Department of Anaesthesiology at an Oncological Institute.

Materials and methods:
The study included 58 patients undergoing laryngeal surgery with varying degrees of airway obstruction, who were divided into two groups: patients ventilated by conventional mechanical ventilation and catheter high-frequency jet ventilation. Patients with cardiac and respiratory comorbidities, obesity and smokers were included. We evaluated the demographic data, effectiveness and safety of the two types of ventilation, and surgeon and anaesthesiologist satisfaction. The effectiveness of ventilation was assessed using arterial blood gas analysis. We were watching for complications such as hypoxia, hypercapnia, barotrauma, laryngospasm and bleeding.

Results:
58 patients were enrolled in the study, 26 (45%) of whom were ventilated by conventional mechanical ventilation and 32 (55%) were ventilated by catheter high-frequency jet ventilation. 72% of the patients were male. Airway obstruction was present in 25 (43%) patients, with the tumour most often located in the supraglottic area. Hypercapnia was more common in the high-frequency ventilation group. The incidence of complication was low, barotrauma or laryngospasm were not recorded. Hypoxia was present in 3 cases (9.4%) of patients ventilated by catheter high-frequency jet ventilation. In 2 cases there was catheter displacement which necessitated conversion to conventional ventilation in one case. The surgeons preferred high-frequency ventilation.

Conclusion:
Catheter high-frequency ventilation is effective and safe even under the conditions of various degree of airway obstruction. This approach reduces the risk of entry of debris and blood into the airway and provides a clear surgical field.

Keywords: high-frequency jet ventilation; catheter; airways obstruction

Received: March 4, 2018; Accepted: May 27, 2018; Published: August 1, 2018  Show citation