A. Aloy et al., SUPERIMPOSED HIGH-FREQUENCY JET VENTILATI ON (SHFJV) IN PATIENTS WITHMASSIVE STENOSIS OF THE LARYNX, Laryngo-, Rhino-, Otologie, 73(8), 1994, pp. 405-411
Massive stenosis of the larynx may present a potentially life-threaten
ing situation for the patient, requiring immediate measures to ensure
a patient's airway. The aim of this prospective study was to evaluate
potential benefits of Superimposed High Frequency Jet Ventilation (SHF
JV) in patients requiring microlaryngeal surgery due to massive stenos
is of the larynx. Patients and methods: 23 patients (age range 1,5 to
90 years) with laryngeal stenosis grade 2 and 3 according to the Cotto
n scale were ventilated using SHFJV The duration of the SHFJV was 12 t
o 116 minutes. SHFJV was performed using a Bronchotron Respirator via
a jet-laryngoscope. Results: Arterial blood gases demonstrated paO2 be
tween 71 and 295 mmHg and paCO2 of 28 to 81 mmHg. The mean FiO2 applie
d was 61,75 +/- 19,26. The airway pressure was measured at the tip of
the jet-laryngoscope and was between 6 and 15 mmHg, and PEEP was 1 to
5 mmHg. In 13 patients a CO2 laser was utilised during surgery. Discus
sion: In all patients SHFJV was performed without problems. Since the
ventilation is delivered above ans possible stenosis the danger of bar
otrauma is minimised. The surgeon obtains optimal visibility of the la
rynx and is not obstructed in the surgical procedure. SHFJV enables bo
th the surgeon and the anesthesist to perform their respective duties
and therefore increases the safety of the patient in the management of
such a difficult problem as massive stenosis of the larynx.