High-frequency jet ventilation in endolaryngeal surgery.
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.


METHODS
Evaluation of different modalities of HFJV.


METHODS
Operating rooms and otolaryngology intensive care unit in a medical institute.


METHODS
218 patients undergoing elective endolaryngeal surgery.


METHODS
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.


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.


CONCLUSIONS
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.
Strashnov
V I
VI
Department of Anesthesiology and Resuscitation, First Medical Institute, St. Petersburg, Russia.
Pluzhnikov
M S
MS
Kolotilov
L V
LV
Gir
E E
EE
Ouchvatkina
M K
MK
D000136:Acid-Base Equilibrium; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000502:physiology; D002196:Capillaries; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output / Q000502:physiology; D002404:Catheterization / Q000295:instrumentation; D017558:Elective Surgical Procedures; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D007830:Larynx / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009092:Mucous Membrane / Q000502:physiology; D010100:Oxygen / Q000097:blood; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012123:Pulmonary Ventilation / Q000502:physiology; D014132:Trachea / Q000502:physiology; D014139:Tracheostomy / Q000295:instrumentation
D002245:Carbon Dioxide; D010100:Oxygen