[Transtracheal jet ventilation with spontaneous ventilation in neoplastic laryngeal dyspnea].
In six suffocating patients with a severe upper airway obstruction (three patients after direct laryngoscopy under general anaesthesia and three patients with cervical tumor scheduled for a difficult tracheostomy), jet-ventilation was delivered using a transtracheal catheter. The jet-ventilator insufflated oxygen only when the tracheal pressure was below a preset value, during spontaneous inspiration. During expiration, tracheal pressure increased above the preset value, the ventilator stopped the insufflation and the expiratory gases escaped through the upper airway. This method corresponds to an inspiratory support without intubation. In post-anaesthesia patients, oxygenation and alveolar ventilation were improved, allowing the avoidance of tracheostomy. In the other patients, tracheostomy was made possible with good surgical conditions under general anaesthesia. This method can be applied in conscious patients and allows oxygenation of suffocating patients.
Bourgain
J L
JL
Service d'anesthésie, institut Gustave-Roussy, Villejuif, France.
Desruennes
E
E
Julieron
M
M
D000328:Adult; D000368:Aged; D001469:Barotrauma / Q000517:prevention & control; D004417:Dyspnea / Q000209:etiology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006611:High-Frequency Jet Ventilation / Q000379:methods*; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000628:therapy*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000150:complications; D014140:Tracheotomy
Jet-ventilation transtrachéale avec ventilation spontanée lors des dyspnées laryngées d'origine néoplasique.