Ihra G, Hieber C, Schabernig C, Kraincuk P, Adel S, Plöchl W, Aloy A
Department of Anaesthesiology and General Intensive Care, University of Vienna, AKH, Austria.
Br J Anaesth. 1999 Dec;83(6):940-2. doi: 10.1093/bja/83.6.940.
We have developed a new technique of combined high-frequency jet ventilation (HFJV), characterized by simultaneous application of a low-frequency (LF) and a high-frequency (HF) jet stream. Tubeless supralaryngeal jet ventilation was delivered via a modified Kleinsasser laryngoscope. We studied 44 adults undergoing 45 elective surgical procedures of the larynx and trachea using a carbon dioxide laser during HFJV. Applied inspiratory oxygen ratios ranged from 0.4 to 1.0. Mean driving pressures of the HF and LF jet streams were 1.5 bar and 1.8 bar in adults, respectively. Mean duration of HFJV was 41 (range 10-180) min. HFJV resulted in mean PaO2 and PaCO2 values of 16.6 (range 9.8-26.9) kPa and 5.7 (3.0-7.6) kPa, respectively. Tubeless supralaryngeal HFJV was safe and effective in maintaining gas exchange in the presence of laryngeal or tracheal stenoses, providing optimal visibility of anatomical structures, offering maximum space for surgical manipulation, and avoiding the use of combustible material inside the larynx or trachea.
我们开发了一种新的联合高频喷射通气（HFJV）技术，其特点是同时应用低频（LF）和高频（HF）喷射气流。无管喉上喷射通气通过改良的克莱因萨瑟喉镜进行。我们研究了44例接受45例择期喉和气管手术的成年人，手术中使用二氧化碳激光并采用HFJV。应用的吸气氧比范围为从0.4至1.0。成人HF和LF喷射气流的平均驱动压力分别为1.5巴和1.8巴。HFJV的平均持续时间为41（范围10 - 180）分钟。HFJV导致平均动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）值分别为16.6（范围9.8 - 26.9）千帕和5.7（3.0 - 7.6）千帕。无管喉上HFJV在存在喉或气管狭窄的情况下维持气体交换方面安全有效，能提供解剖结构的最佳视野，为手术操作提供最大空间，并避免在喉或气管内使用易燃材料。
