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British Journal of Anaesthesia, 1973, Vol. 45, No. 7 733-737
© 1973 The Board of Management and Trustees of the British Journal of Anaesthesia

other

FURTHER STUDIES ON TRANSTRACHEAL VENTILATION: THE INFLUENCE OF UPPER AIRWAY OBSTRUCTION ON THE PATTERNS OF PRESSURE AND VOLUME CHANGES

K. CHAKRAVARTY, D.A., F.F.A.R.C.S.(I), P. S. NARAYANAN, M.S., F.R.C.S.(ENG), F.R.C.S.(EDIN) and W. E. SPOEREL, M.D., F.R.C.P.(C)

Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry-6, India
Department of Thoracic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research Pondicherry-6, India
Department of Anaesthesiology, University of Western Ontario London, Canada

The influence of partial obstruction of the upper airway on the pressure and volume changes during transtracheal ventilation has been studied on a model. It was found that obstruction of the airway proximal to the jet tends to increase the time required for inflation and deflation of the lung and also produces a higher inflation pressure, all proportional to the severity of the obstruction. While the tidal exchange remains largely unaffected, there will be hyperinflation of the lung with an increased functional residual volume. Careful adjustment of the pattern of ventilation is necessary for the safe use of transtracheal ventilation with upper airway obstruction, particularly when such obstruction is produced by stenosing lesions or by instrumentation during laryngoscopy or oesophagoscopy.


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