Two-lung high-frequency jet ventilation as an alternative ventilation technique during transthoracic esophagectomy.
OBJECTIVE
The aim of this study was to evaluate two-lung high-frequency jet ventilation during esophagectomy and evaluate the influence of high-frequency jet ventilation on pulmonary complications as compared with one-lung ventilation.


METHODS
A retrospective study.


METHODS
A single-center study in a university hospital.


METHODS
The authors analyzed the data of patients who had undergone an elective esophagectomy by transthoracic esophagectomy between January 2000 and December 2006.


METHODS
The patients had undergone a cervicothoracoabdominal subtotal esophagectomy via a right-sided thoracotomy. Patients with high-frequency jet ventilation were intubated with a single-lumen endotracheal tube, and an oxygen insufflation catheter was placed inside the endotracheal tube and connected to a high-frequency jet ventilator.


RESULTS
Eighty-seven patients were enrolled, 30 with high-frequency jet ventilation and 57 with 1-lung ventilation. Both groups were adequately oxygenated, but patients in the one-lung ventilation group had a higher PaCO2 (42.75 +/- 7.5 mm Hg) compared with that for the high-frequency jet ventilation group (35.25 +/- 8.25 mm Hg) (p < 0.05). There were no differences in postoperative respiratory complications between the 2 groups. Mean blood loss was significantly lower for patients in the high-frequency jet ventilation group (1,243 +/- 787 mL).


CONCLUSIONS
High-frequency jet ventilation to 2 lungs, using a single-lumen tube, is a safe and adequate ventilation technique for use during esophagectomy. High-frequency jet ventilation had no influence on the incidence of postoperative pulmonary complications but reduced perioperative blood loss and led to a decreased need for fluid replacement.
Buise
Marc
M
Department of Anesthesiology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. marc.buise@cze.nl
van Bommel
Jasper
J
van Genderen
Michel
M
Tilanus
Huug
H
van Zundert
André
A
Gommers
Diederik
D
D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000517:prevention & control; D000077324:Crystalloid Solutions; D016629:Esophagectomy; D005260:Female; D005440:Fluid Therapy; D006611:High-Frequency Jet Ventilation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016683:Supine Position
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010100:Oxygen