Jet ventilation

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Jet ventilation is a special form of ventilation for surgical interventions on the airways under anesthesia . It is understood as the intermittent application of ventilation gas under high pressure through thin and unblocked lines into the airways that are open to the outside. The main difference to conventional ventilation lies in the fact that with jet ventilation the dead space is of far less importance and is not only based on alveolar ventilation. Gas exchange is the result of several additive and supportive mechanisms that together lead to a continuous leaching of the lungs with fresh (oxygen-rich) gas and the removal of used (carbon dioxide-rich and oxygen-poor) gas.

Since relatively large volumes of gas flow through narrow pipes and nozzles, the gas particles are accelerated to very high speeds. This creates the characteristic flow noises which justify the use of the “jet” term. It has become common to speak of low or normal frequency jet ventilation (NFJV) at <1 Hz and high frequency jet ventilation (HFJV) at 1–10 Hz.

The surgical indication area for HFJV is currently limited to diagnostic and surgical interventions on the larynx , airways and lungs . These are endoscopically performed diagnostic and surgical interventions with a rigid bronchoscope , support laryngoscope , various optics and binocular microscope .

These operations are based on microlaryngoscopy with exposure of the operating area using a Kleinsasser instrument or a modification of the same. Both microsurgical techniques and laser resections are used here. Deeper lesions are approached directly (transcutaneously), as in the case of trachea or bronchus resections , plasty or surgery on the tracheostoma . The combination of both approaches occurs during the implantation and explantation of laryngotracheal stents and voice prostheses .

See also

HFOV ventilation

literature

  • G. Ihra, G. Gockner, A. Kashanipour, A. Aloy: High-frequency jet ventilation in European and North American institutions: developments and clinical practice. In: European journal of anaesthesiology. Volume 17, Number 7, July 2000, pp. 418-430, PMID 10964143 .