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High-frequency jet ventilation – a review of its role in laryngology

Published online by Cambridge University Press:  29 June 2007

K. L. Evans ,
M. H. Keene  and
A. S. E. Bristow
K. L. Evans
Affiliation:
Ear, Nose and Throat Department, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.
M. H. Keene
Affiliation:
Ear, Nose and Throat Department, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.
A. S. E. Bristow*
Affiliation:
Directorate of Anaesthesia, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.
*
Dr A. S. E. Bristow, F.R.C.A., Consultant Anaesthetist, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.
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Abstract

High-frequency jet ventilation (HFJV) is a safe, effective anaesthetic technique with a low risk of aspiration which has not yet gained wide acceptance in laryngology. Following anaesthesia and muscular relaxation the patient is intubated with a size 7FG infant feeding catheter and ventilation is achieved by delivering small bursts of anaesthetic gas at high frequency. The mechanisms of gas exchange are thought to be little different from those of conventional ventilation. We have found HFJV to be of value in laryngoscopy, laryngo-tracheal reconstruction, tracheoplasty, bronchoscopy and tonsillectomy.

The advantages include:

(a) ease of intubation, especially in the presence of a supraglottic mass;

(b) improved surgical access compared with a conventional endotracheal tube; and

(c) protection of the airway by the inherent ‘auto-PEEP’ effect. Care must be taken to ensure that conditions allow adequate exhaust of expired gas. Humidification of inspired gas is essential during prolonged procedures.

Keywords

High-frequency jet ventilationAnaesthesiaLaryngoscopy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 1 , January 1994 , pp. 23 - 25
Copyright
Copyright © JLO (1984) Limited 1994

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