Clinical Application of Percutaneous Transtracheal Catheter Insertion on Jet Ventilation

Abstract

Background: High frequency jet ventilation has been extensively evaluated by clinicians and is considered reliable technique for assisted ventilation, occupying a specific place in the wide range of ventilatory support techniques available for anesthesia and critical care. Thanks to the transtracheal high frequency jet ventilator, it is now possible to assure a free laryngeal endoscopic operative field. The transtracheal catheter is introduced percutaneously through the cricothyroid membrane into the trachea and connected to a high frequency jet ventilator. The purpose of this study is to evaluate the application of percutaneous transtracheal HFJV for suspension micro laryngeal surgery under total intravenous anesthesia. Methods: The patients were divided into two groups. In transtracheal group(group TT, n=7), jet ventilation was done with 14 gauge angiocatheter introduced into the trachea through the cricothyroid membrane and in endotracheal intubation group (group ET, n=7), jet ventilation was done with endotracheal tube which has a 5 mm of internal diameter. Results: The blood pressures were not significantly changed except postincision 5 minute in group ET and TT. The heart rate was not significantly changed in group ET and TT. The arterial blood gases were not significantly changed in group ET and TT. Conclusions: From the above results, jet ventilation by transtracheal catheter, if properly used, should provide safe airway, an adequate ventilation and improved visual field. So we suggest that transtracheal technique should provide an alternative to conventional endotracheal technique for micro laryngeal surgery. (Korean J Anesthesiol 1996; 31: 37-42)