The use of high-frequency jet ventilation for out of operating room anesthesia.

PURPOSE OF REVIEW

High-frequency jet ventilation is a novel technique for providing mechanical ventilation in the out of operating room (OOR) setting. Case reports and a small series of patients have shown it to be useful in patients undergoing cardiac arrhythmia ablations, interventional radiology procedures, and extracorporeal shock wave lithotripsy. Recently, interest in the technique has grown tremendously as the ability to provide superior surgical conditions may lead to improved efficiency and less side-effects in a variety of procedures.

RECENT FINDINGS

Atrial fibrillation ablation procedures, liver tumor ablations, and extracorporeal shock wave lithotripsy are all the procedures that benefit from minimal movement of the heart, liver, and kidney, respectively, during the procedure. Although randomized controlled trials are lacking, increasing data suggest that by maintaining the thoracic and abdominal structures relatively immobile throughout the respiratory cycle, the efficiency and safety of these procedures may be improved.

SUMMARY

Technological advances are allowing an increasing number of surgical procedures to be performed in the OOR setting. Such procedures often depend on the precise application of ablation catheters or shock waves. High-frequency jet ventilation facilitates the improved accuracy of catheter and shock wave placement, as well as efficiency of a variety of procedures. Improved efficiency, with fewer side-effects, has tremendous implications for the growth of such procedures in the OOR setting.