title: Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review.
abstract: The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min-1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation) has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.
authors.affiliation: Department of Anesthesiology, Université catholique de Louvain, CHU UCL Namur, Avenue G. Therasse 1, 5530 Yvoir, Belgium.
authors.forename: Laurie
authors.identifier: 0000-0003-1322-2641
authors.initials: L
authors.lastname: Putz
authors.affiliation: Department of Anesthesiology, Université catholique de Louvain, CHU UCL Namur, Avenue G. Therasse 1, 5530 Yvoir, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Mayné
authors.affiliation: Department of Anesthesiology, Université catholique de Louvain, CHU UCL Namur, Avenue G. Therasse 1, 5530 Yvoir, Belgium.
authors.forename: Anne-Sophie
authors.identifier: 0000-0001-6738-5601
authors.initials: AS
authors.lastname: Dincq
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D001469:Barotrauma / Q000503:physiopathology; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002245:Carbon Dioxide / Q000737:chemistry; D006611:High-Frequency Jet Ventilation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008176:Lung Volume Measurements
chemical_list: D002245:Carbon Dioxide