High-frequency jet ventilation in interventional bronchoscopy: factors with predictive value on high-frequency jet ventilation complications.
OBJECTIVE
To evaluate the incidence and impact on clinical outcome of complications observed during high-frequency jet ventilation (HFJV) at interventional bronchoscopy and to identify the perioperative factors that may be associated to an increased incidence of such complications.


METHODS
Observational retrospective, study with an observational prospective validation of the statistically significant associations.


METHODS
University hospital.


METHODS
The retrospective study involved 276 patients who underwent an interventional rigid bronchoscopy during general anesthesia and HFJV. Forty consecutive patients were accrued for the prospective validation group. INTERVENTIONS/MEASUREMENTS: Information recorded included patient medical history and perioperative complications observed at HFJV-managed bronchoscopic procedures and their impact on clinical outcome until hospital discharge.


RESULTS
At least one complication was detected in 38% of retrospective patients and 55% of prospective patients. Most frequent complications were hypercapnia, hypoxemia, and hemodynamic instability, but just one case of barotrauma in the retrospective group. Despite the high incidence, these complications were transient and did not increase hospital stay, whereas technical failure to widen airway lumen was associated with an adverse prognosis. Several clinical parameters showed a significant association with complications in the univariate analysis. However, the multivariate analysis only evidenced two independent predictive factors: the ASA physical status scale and baseline oxygen saturation.


CONCLUSIONS
Classification in ASA physical status IV group and a baseline oxygen saturation of 95% or less independently predicted the development of complications during interventional rigid bronchoscopy with HFJV.
Fernandez-Bustamante
Ana
A
Department of Anesthesiology, University Hospital, 12 de Octubre Av. Andalucia Km 5.4, 28041 Madrid, Spain. aferna10@jhmi.edu
Ibañez
Vicenta
V
Alfaro
José J
JJ
de Miguel
Eduardo
E
Germán
María J
MJ
Mayo
Agustín
A
Jimeno
Antonio
A
Pérez-Cerdá
Francisco
F
Escribano
Pedro M
PM
D000768:Anesthesia, General; D001982:Bronchial Diseases / Q000628:therapy*; D001999:Bronchoscopy / Q000379:methods*; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D006611:High-Frequency Jet Ventilation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014135:Tracheal Stenosis / Q000628:therapy*