Alternative Ventilatory Techniques
Most patients undergoing thoracic surgical procedures suffer from some degree of pulmonary disease which impacts their ventilatory management. Traditional modes of positive pressure mechanical ventilation are familiar to the general practitioner (Box 11-1) (Fig 11-1) and have been well reviewed (1). Variations on these common modes, dictated by pathophysiology (e.g., longer expiratory time for obstructive pulmonary disease, etc.) should also be familiar (2). The focus of this chapter will be alternative ventilatory techniques that may be necessary during specific thoracic surgical procedures or situations, when traditional ventilatory techniques are inadequate. Such alternative techniques (e.g., jet ventilation, high frequency ventilation (HFV), etc.) may be used as the primary mode of ventilation, or as an adjunct in various thoracic surgical situations.
KeywordsVentilatory management Alternative ventilatory techniques Jet ventilation Bernoulli’s Principle Venturi Effect High frequency ventilation High frequency positive pressure ventilation High frequency jet ventilation High frequency oscillatory ventilation High frequency flow interruption Apneic insufflation Differential ventilation Noninvasive positive pressure ventilation
- 1.Tobin MJ, editor. Principles and practice of mechanical ventilation. New York: McGraw-Hill; 2006.Google Scholar
- 2.Lumb AB, editor. Nunn’s: applied respiratory physiology. Philadelphia: Butterworth & Heinemannn; 2000.Google Scholar
- 4.Benumof JL, editor. Anesthesia for thoracic surgery. Philadelphia: WB Saunders; 1995.Google Scholar
Further Suggested Reading
- Kaplan JA, Slinger PD, editors. Thoracic anesthesia. Churchill-Livingston: Elsevier Science; 2003.Google Scholar