Gulleth Yusuf, Spiro Jeffrey
University of Connecticut School of Medicine, Farmington 06030, USA.
Arch Otolaryngol Head Neck Surg. 2005 Oct;131(10):886-90. doi: 10.1001/archotol.131.10.886.
To assess the safety and efficacy of percutaneous transtracheal jet ventilation (PTJV) in the management of the difficult airway.
Retrospective case series.
Academic, tertiary care medical center.
Forty-three consecutive PTJV procedures performed on 33 patients with anticipated airway difficulty undergoing direct laryngoscopy for diagnosis and/or treatment of head and neck cancer (91%) or benign lesions.
Duration of PTJV, oxygen saturation values by pulse oximetry, and incidence of tracheotomy and complications.
The mean duration of PTJV was 43 minutes, and mean minimum oxygen saturation was 97%. Biopsy was performed in 27 (62%) of the cases, and a laser excision in 12 (28%). Seven tracheotomies were planned preoperatively, and 2 were performed intraoperatively. Two additional patients required tracheotomies in the immediate postoperative period. Two (5%) complications occurred: 1 pneumothorax that resolved with chest tube insertion and 1 kinked catheter resulting in soft tissue emphysema that resolved spontaneously.
Percutaneous transtracheal jet ventilation is a safe and effective method of ventilation in patients with anticipated airway difficulty. It is particularly useful in patients who are not in immediate airway distress preoperatively but who may be difficult or impossible to intubate after induction of general anesthesia. Percutaneous transtracheal jet ventilation may help to avoid tracheotomy in this setting and should be routinely available as an option for airway management in patients with head and neck cancer.
评估经皮气管喷射通气（PTJV）在处理困难气道中的安全性和有效性。
回顾性病例系列。
学术性三级医疗中心。
对33例预计气道困难的患者连续进行了43次PTJV操作，这些患者因诊断和/或治疗头颈癌（91%）或良性病变而接受直接喉镜检查。
PTJV持续时间、脉搏血氧饱和度测定的氧饱和度值、气管切开术发生率及并发症。
PTJV的平均持续时间为43分钟，平均最低氧饱和度为97%。27例（62%）进行了活检，12例（28%）进行了激光切除。7例术前计划行气管切开术，2例术中进行了气管切开术。另外2例患者在术后即刻需要行气管切开术。发生了2例（5%）并发症：1例气胸经胸腔置管后缓解，1例导管扭曲导致软组织气肿，自行缓解。
经皮气管喷射通气是处理预计气道困难患者的一种安全有效的通气方法。对于术前无即刻气道窘迫但在全身麻醉诱导后可能难以或无法插管的患者尤其有用。在这种情况下，经皮气管喷射通气可能有助于避免气管切开术，应作为头颈癌患者气道管理的常规选择。
