title: Supraglottic jet ventilation in difficult airway management.
abstract: BACKGROUND
  Supraglottic jet ventilation (SJV) via the "jet endotracheal tube" (JET) designed by Wei (WEI JET; Wei Medical LLC, Cherry Hill, NJ) provides adequate oxygenation and ventilation during direct laryngoscopy and tracheal intubation in animals. It has facilitated intubation in apneic pigs with a simulated difficult airway.
  
  
  OBJECTIVE
  To report on the first clinical study to examine the efficacy of using SJV via the WEI JET, in combination with end-tidal CO(2) pressure (PetCO(2)) monitoring during SJV, in maintaining oxygenation during direct laryngoscopy, and in facilitating placement of the WEI JET, and comparing it to the standard intubation technique using a conventional endotracheal tube. The relative safety of using SJV via the WEI JET in airway management was also addressed to provide the foundation for a larger-scale clinical study using the WEI JET, to be carried out in the future.
  
  
  METHODS
  Patients in the control group were intubated with a conventional endotracheal tube, and patients in the experimental group were intubated with a WEI JET. The effectiveness of SJV through a WEI JET in maintaining proper oxygenation, and the use of PetCO(2) monitoring to facilitate intubation, were studied and compared to the control group. Complications such as sore throat, laryngospasm, and barotrauma were recorded during the study and 24 h after extubation.
  
  
  RESULTS
  In the WEI JET group, pulse oxygen saturation (SpO(2)) was 100% in all patients during intubation. No serious complications were detected, and the incidence of minor complications was comparable to the control group. Under PetCO(2) guidance, 100% of patients in the WEI JET group were intubated on the first attempt, compared to 30% of Grade III view patients in the control group, who required two attempts.
  
  
  CONCLUSIONS
  Using the WEI JET with SJV provides adequate oxygenation during tracheal intubation in apneic patients for a prolonged period of time, with no difference in complications compared to the standard intubation technique. PetCO(2) monitoring facilitated intubation in patients with a Grade III glottis view.
authors.affiliation: Department of Anesthesiology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Peng
authors.forename: Jianhong
authors.initials: J
authors.lastname: Ye
authors.forename: Yifan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Jianjun
authors.initials: J
authors.lastname: Liang
authors.forename: Hailiang
authors.initials: H
authors.lastname: Huang
authors.forename: Huafeng
authors.initials: H
authors.lastname: Wei
authors.forename: Shuling
authors.initials: S
authors.lastname: Peng
mesh_terms: D000328:Adult; D002245:Carbon Dioxide; D045853:Exhalation; D005260:Female; D005931:Glottis; D006611:High-Frequency Jet Ventilation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D010612:Pharyngitis / Q000209:etiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen