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British Journal of Anaesthesia, 2001, Vol. 87, No. 6 870-875
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Transtracheal high frequency jet ventilation for endoscopic airway surgery: a multicentre study

J. L. Bourgain*,1, E. Desruennes1, M. Fischler2 and P. Ravussin3

1Service d’Anesthésie, Institut Gustave Roussy, Rue Camille Desmoulins, F-94800 Villejuif, France. 2Service d’Anesthésie, Hôpital Foch, 40 rue Worth, F-92151 Suresnes, France. 3Département d’Anesthésiologie et de réanimation, CHU Sion and Lausanne, Switzerland*Corresponding author

Serious complications during high frequency jet ventilation (HFJV) are rare and have been documented in animals and in case reports or short series of patients with a difficult airway. We report complications of transtracheal HFFJV in a prospective multicentre study of 643 patients having laryngoscopy or laryngeal laser surgery. A transtracheal catheter could not be inserted in two patients (0.3%). Subcutaneous emphysema (8.4%) was more frequent after multiple tracheal punctures. There were seven pneumothoraces (1%), two after laser damage to the injector, one after difficult laryngoscopy, four with no clear cause. Arterial desaturation of oxygen was more frequent during laser surgery and in overweight patients. Transtracheal ventilation from a ventilator with an automatic cut-off device is a reliable method for experienced users. Control of airway pressure does not prevent a low frequency of pneumothorax.

Br J Anaesth 2001; 87: 870–5


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