title: The Veres adapter: clinical experience with a new device for jet ventilation via a laryngeal mask airway during flexible bronchoscopy.
abstract: BACKGROUND
  A new device was developed to deliver high-frequency jet ventilation via a laryngeal mask airway (LMA). We investigated its use during flexible fiberoptic bronchoscopy in anesthetized patients.
  
  
  METHODS
  Thirty adults were studied during interventional bronchoscopy. After facemask ventilation, the Veres adapter was connected to a size 4 or 5 LMA, and superimposed high-frequency jet ventilation was performed. Oxygen saturation, transcutaneous carbon dioxide, supraglottic airway pressure, and hemodynamic data were recorded and analyzed.
  
  
  RESULTS
  Procedures were performed under stable hemodynamic conditions. Short procedure times and fast recovery were observed. Mild hypercapnia was the most common minor adverse effect (n = 16). One patient developed a pneumothorax after peripheral biopsy, 1 patient had a stiff chest during bronchoscopy, resulting in high airway pressures, and 1 patient required continuous positive airway pressure mask ventilation in the postoperative care unit.
  
  
  CONCLUSIONS
  We report the clinical use of the Veres adapter in conjunction with an LMA to achieve rapid surgical access and adequate ventilation during flexible bronchoscopy. As an alternative to the use of an endotracheal tube, the new system may better maintain the airway during interventional and diagnostic bronchoscopy because of the larger diameter conduit.
authors.affiliation: Department of Pulmonology, Landesklinikum Krems, Krems an der Donau, Vienna, Austria.
authors.forename: Jan
authors.initials: J
authors.lastname: Veres
authors.forename: Krisztina
authors.initials: K
authors.lastname: Slavei
authors.forename: Peter
authors.initials: P
authors.lastname: Errhalt
authors.forename: Michaela
authors.initials: M
authors.lastname: Seyr
authors.forename: Gerald
authors.initials: G
authors.lastname: Ihra
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D018583:Pliability