TRANSTRACHEAL JET-VENTILATION ASSOCIATED WITH SPONTANEOUS BREATHING IN NEOPLASTIC LARYNGEAL DYSPNEA

In six suffocating patients with a severe upper airway obstruction (th ree patients after direct laryngoscopy under general anaesthesia and t hree patients with cervival tumor scheduled for a difficult tracheosto my), jet-ventilation was delivered using a transtracheal catheter. The jet-ventilator insufflated oxygen only when the tracheal pressure was below a preset value, during spontaneous inspiration. During expirati on, tracheal pressure increased above the preset value, the ventilator stopped the insufflation and the expiratory gases escaped through the upper airway. This method corresponds to an inspiratory support witho ut intubation. In postanaesthesia patients, oxygenation and alveolar v entilation were improved, allowing the avoidance of tracheostomy. in t he other patients, tracheostomy was made possible with good surgical c onditions under general anaesthesia. This method can be applied in con scious patients and allows oxygenation of suffocating patients.