The clinical value of high-frequency jet ventilation in major airway reconstructive surgery.

High-frequency jet ventilation (HFJV) via a catheter with internal diameter 2.4 mm was employed in 21 patients to facilitate airway reconstructive surgery. Tracheal reconstruction was performed in six cases, sleeve lobectomy in six and sleeve pneumonectomy in nine. An HFO-Jet-Ventilator was used at individually selected settings of 0.5-2.4 kg/cm2 for driving gas pressure and 4-10 Hz frequency. Intermittent positive pressure ventilation (IPPV) was used initially, with switch to HFJV at the time of tracheobronchial reconstruction. The time during which HFJV was employed ranged from 25 to 65 min. Except for transient hypoxia or hypercapnia in a few patients, the results of blood gas analyses during HFJV were satisfactory. The most appropriate HFJV settings for each surgical procedure and the advantages of HFJV over IPPV are discussed.