title: Methods of administering superimposed high-frequency jet ventilation and the associated risk for aspiration in a model of tracheal bleeding.
abstract: BACKGROUND
  To determine the suitability of different superimposed high-frequency jet ventilation (SHFJV) application methods during tracheal bleeding.
  
  
  OBJECTIVE
  To determine the effect of SHFJV on the aspiration of blood during tracheal bleeding.
  
  
  METHODS
  A test lung was ventilated using SHFJV via a rigid endoscope, a jet laryngoscope and a 4-lumen jet catheter. Packed red blood cells (PRBCs) were injected into the artificial trachea caudally to the rigid endoscope and jet laryngoscope ventilation, and both caudally and cranially during ventilation via the 4-lumen jet catheter, and the migration of PRBCs during ventilation was studied using continuous video recording.
  
  
  RESULTS
  Migration of blood into the lower respiratory tract did not occur during SHFJV via the rigid endoscope and jet laryngoscope and via the 4-lumen jet catheter with the bleeding caudal to ventilation source. If the bleeding was cranial to the 4-lumen jet catheter ventilation, migration of blood into the lower respiratory tract was seen when reflux of blood reached the entrainment area. From this area, blood is transported within the jet stream into the lower respiratory tract.
  
  
  CONCLUSIONS
  SHFJV protects the lower respiratory tract from blood aspiration in case of tracheal bleeding. During SHFJV via the 4-lumen jet catheter, aspiration of blood only occurs if bleeding is localized cranial to the 4-lumen jet catheter ventilation. In case of heavy tracheal bleeding, the jet sources should be positioned cranial to the site of bleeding.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Dresden Friedrichstadt Hospital, Academic Teaching Hospital, Technical University of Dresden, Dresden, Germany. nowak-an@khdf.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Nowak
authors.forename: Taras
authors.initials: T
authors.lastname: Usichenko
authors.forename: Michael
authors.initials: M
authors.lastname: Wendt
authors.forename: Eckart
authors.initials: E
authors.lastname: Klemm
mesh_terms: D001237:Asphyxia / Q000209:etiology / Q000517:prevention & control*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006470:Hemorrhage / Q000150:complications*; D006611:High-Frequency Jet Ventilation / Q000295:instrumentation*; D006801:Humans; D020704:Laryngoscopes; D008954:Models, Biological; D014133:Tracheal Diseases / Q000150:complications*