High frequency jet ventilation in exploration of tracheostomy--a case report.
Exploration of tracheostomy is not uncommon, however, in case a patient with a facial reconstruction flap, trouble may arise because of difficulty in intubation. We hereby report a patient who had a fresh facial reconstruction flap after radical resection of buccal carcinoma, sustained bleeding around the tracheostomy and was scheduled for exploration of tracheostomy. Fiberoptic oral intubation was failed because of profuse secretion and edematous oral mucosa; high frequency jet ventilation (HFJV) was thus applied and made possible with a suction catheter put through the tracheostomy tube. Exploration was performed following withdrawal of the tracheostomy tube. The tracheostomy tube was reinserted under the guidance of the in-place suction tube after uneventful exploration. The probable concomitant complications and contraindications of using HFJV are discussed here. With thorough preparation and careful monitoring, and under the supervision of experienced physicians, transtracheal HFJV can substitute fiberoptic intubation for ventilation in case of exploration of tracheostomy.
Chung
Peter Chi-Ho
PC
Department of Anesthesiology, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Ng
Yuet-Tong
YT
Hsieh
Jing-Ru
JR
Lau
Wai-Meng
WM
Hui
Yu-Ling
YL
Yu
Chung-Cheung
CC
D006611:High-Frequency Jet Ventilation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014139:Tracheostomy / Q000379:methods*