Abstract
Intermittent jet ventilation was used during anaesthesia in a 66-yr-old woman who had severe tracheal narrowing secondary to compression by a retrosternal goitre. The trachea was intubated by a smallbore tube, which was placed above the site of narrowing. An injector was connected to the proximal end of the tracheal tube on one side and to the anaesthesia circuit on the other. Intermittent jets of 66% nitrous oxide in oxygen via the injector resulted in adequate oxygenation and carbon dioxide elimination. Arterial blood gas analysis during jet ventilation showed PaO2 150 mmHg, PaCO2 35 mmHg and pH 7.4. It is concluded that lowfrequency jet ventilation may provide adequate oxygenation and carbon dioxide elimination in the presence of tracheal narrowing.
Résumé
On a utilisé la ventilation intermittente à jet pendant l’anesthésie d’une femme de 66 ans souffrant dun rétrécissement trachéal serré causé par un goitre rétrosternal. La trachée est intubée d’abord avec un tube de petit calibre placé au dessus du rétrécissement. Un injecteur est branché sur l’extrémité proximale du tube endotrachéal d’un côté et sur le circuit anesthésique de l’autre. Des jets intermittents de protoxyde d’azote 66% avec oxygène produisent une oxygénation et une élimination du gaz carbonique adéquates. L’analyse des gaz artériels montre une PaO2 de 150 mmHg, une PaCO2 de 35 mmHg et un pH de 7,4. Nous concluons que la ventilation par jet à basse fréquence peut procurer une oxygenation et une élimination du gaz carbonique adéquates en présence d’un rétrécissement serré de la trachée.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Baraka A. Oxygen-jet ventilation during tracheal reconstruction in patients with tracheal stenosis. Anesth Analg 1977; 56: 429–32.
Baraka A, Mansour R, Abou Jaoude C, Muallem M, Hatem J, Jaraki K. Entrainment of oxygen and halothane during jet ventilation in patients undergoing excision of tracheal and bronchial tumors. Anesth Analg 1986; 65: 191–4.
Pullerits J, Holzman R. Anaesthesia for patients with mediastinal masses. Can J Anaesth 1989; 36: 681–8.
Benumof JL. Tracheal resection.In: Benumof JL (Ed.). Anesthesia for Thoracic Surgery. Philadelphia: W.B. Saunders Company, 1987; 349–55.
Sibert KS, Biondi JW, Hirsch NP. Spontaneous respiration during thoracotomy in a patient with mediastinal mass. Anesth Analg 1987; 66: 904–7.
Dworkin R, Benumof JL, Benumof R, Karagianes TG. The effective tracheal diameter that causes air trapping during jet ventilation. Journal of Cardiothoracic Anesthesia 1990; 4: 731–6.
Benumof JL, Scheller MS. The importance of transtracheal jet ventilation in the management of the difficult airway. Anesthesiology 1989; 71: 769–78.
O’Sullivan TJ, Healy GB. Complications of Venturi jet ventilation during microlaryngeal surgery. Archives of Otolaryngology 1985; 111: 127–31.
Sanders RD. Two ventilation attachments for bronchoscopes. Del Med J 1967; 39: 170–5.
Carlon GC, Griffin J, Ray C Jr,Groeger JS, Patrick K. High frequency jet ventilation in experimental airway disruption. Crit Care Med 1983; 11: 353–5.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Baraka, A., Muallem, M., Jamhoury, M. et al. Jet ventilation in a case of tracheal obstruction secondary to a retrosternal goitre. Can J Anaesth 40, 875–878 (1993). https://doi.org/10.1007/BF03009261
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009261