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Background: Supraglottic jet ventilation (JV(S)) with injectors above airway stenoses may result in inadvertent high lung pressures. We designed this study to investigate intrinsic positive end-expiratory pressure (PEEP(i)) during jet ventilation via a distant injector in a model of dynamic upper airway obstruction.
Methods: Respiratory pressure-time curves were recorded during JV(S) in a tracheal lung model using a pig's trachea and an embolectomy catheter's air-filled balloon to simulate 60 and 80% airway obstruction. JV(S) was performed at various jet frequencies (F(jet) 30 min(-1), 60 min(-1), and 100 min(-1)) and driving pressures (1 bar and 2 bar).
Results: JV(S) was associated with generation of PEEP(i), which depended on driving pressure, the degree of obstruction, and on ventilatory frequency.
Conclusions: In the presence of a dynamic upper airway obstruction, JV(S) via a distant injector may result in PEEP(i), which cannot be detected when airway pressure is measured in front of the obstruction.
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http://dx.doi.org/10.1213/ANE.0b013e3181e9c45c | DOI Listing |
J Anesth
August 2025
Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 507 Zhengmin Road, Shanghai, 200043, China.
Background: Supraglottic jet ventilation (SJV) is used during flexible bronchoscopy to improve oxygenation, but its impact on overall lung ventilation is unclear. Thoracic electrical impedance tomography (EIT) offers real-time monitoring of respiratory function.
Methods: This prospective pilot study enrolled patients undergoing flexible bronchoscopy.
Laryngoscope
August 2025
Department of Otolaryngology-Head and Neck Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Introduction: The potential for airway fire during endoscopic laser surgery is well known, typically addressed by reducing FiO levels. This study revisits these established practices in CO laser tubeless airway surgery.
Materials And Methods: Using a cadaveric porcine larynx and lung model, we conducted trials with high-flow (HFV) and jet ventilation.
J Thorac Dis
July 2025
Department of Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Background: To reduce the contamination of the breathing circuit, respiratory filters are used in patients receiving mechanical ventilation. However, their use increases the resistance and dead space volume of the breathing circuit, which potentially leads to asynchrony events, especially when patients are receiving jet nebulization. However, the impact of respiratory filter resistance on respiratory mechanics and human-machine synchronization during invasive ventilation with jet nebulization is not clear.
View Article and Find Full Text PDFCurr Opin Anaesthesiol
August 2025
Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Purpose Of Review: Management of the narrow airway during surgical procedures poses significant challenges, requiring techniques that ensure optimal gas exchange while providing adequate surgical access. This review synthesizes the current understanding, comparing the established role of high-frequency jet ventilation (HFJV) with the advancements offered by flow-controlled ventilation (FCV) in the context of upper airway surgery.
Recent Findings: Recent clinical experience and studies have highlighted the potential advantages of combining a narrow-bore cuffed tube with FCV in terms of surgical access and visibility, enhanced ventilation and gas exchange, reduced complications, and improved safety during laryngeal and tracheal surgery, particularly in patients with significant airway narrowing.
Lung abscesses represent complex localised infections of the lung parenchyma. If they fail to resolve with conventional medical and surgical therapy, they pose a significant clinical challenge, particularly when the lesion is poorly accessible to percutaneous or open drainage. The evolution of advanced bronchoscopic techniques including cone-beam computed tomography (CBCT) and superimposed high-frequency jet ventilation (SHFJV) now allows for precise, minimally invasive interventions in such complex cases.
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