JET-ADAPTER FOR APPLYING SUPERIMPOSED HIG H-FREQUENCY JET VENTILATION(SHFJV) VIA A TUBE IN INTENSIVE-CARE MEDICINE - A TECHNICAL INNOVATION

Despite advances and technical developments in the area of intensive c are medicine is has not been possible to lower the mortality of patien ts with pulmonary insufficiency. Therefore, alternative ventilation st rategies have been developed and applied. One of these ventilation tec hniques is superimposed high-frequency jet ventilation (SHFJV). For op timal application of SHFJV we designed a special jet-adapter. Methods: This jet-adapter made of plastic consists of a T-piece and four centr al, small-bore cannulas and can be connected to any commercially avail able endotracheal tube. Therefore, it does not require reintubation wi th an endotracheal jet tube when beginning SHFJV. The simultaneous hig h-frequency and low-frequency jet ventilation is performed over two je t-nozzles that have been designed according to optimal flow dynamic me asurements. Two further cannulas are used for continuous airway pressu re monitoring and humidification of the applied gases. A pre-warmed an d humidified bias flow with exactly defined oxygen concentration is le d th rough the cross-part of the T-piece for gas entrainment. Addition ally, the cross-part contains a port that can be opened for endotrache al suctioning or bronchoscopy and makes disconnection of the jet adapt er from the endotracheal tube for either purpose unnecessary. Conclusi on: The jet adapter can be used: (1) to apply SHFJV; (2) to measure ai rway pressures continuously; (3) to humidify and warm inspired gases; (4) to administer medications or add nitrous oxide by the inspiratory route, enabling combination with new therapeutic possibilities in the management of patients with severe ARDS.