Jet Ventilator Safety Questioned

Mitchel B. Sosis, M. D., Ph. D.

To the Editor

In his recent article on the choice of tracheal tubes for laser airway surgery (September, 1989 Newsletter), Dr. Saunders has mentioned the technique of Venturi jet ventilation without adequately discussing the complications of this technique. The Venturi technique may allow for pulmonary ventilation without the presence of a tracheal tube and thus should decrease the possibility of an airway fire.

However, jet ventilation may not assure adequate ventilation in those patients who are obese or have decreased lung compliance. let ventilation may also be ineffective if an airway obstruction is present or if the jet is not aligned with the trachea. The high pressure of the jet may cause barotrauma(1) including pneumothorax, (2) pneumo mediastinum pneumo peritoneum, subcutaneous emphysema or gastric dilatation

An additional consideration in the use of jet ventilation is that & absence of a cuffed tracheal tube provides no barrier to the aspiration of gastric contents or debris from surgery. Movement of the vocal cords may occur during jetting which may interfere with surgery.

Mitchel B. Sosis, M. D., Ph. D.

Indiana University Medical Center Indianapolis, IN

References

  1. O’Sullivan TJ, Healy GB Complications of Venturi jet ventilation during micro laryngeal surgery. Arch Otolaryngol 111:127-131,1985.
  2. Oliverio R, RuderCB Ferman C, Cura A. Pneumothosecondary to bafl-valve obstruction during jet ventilation. Anesthesiology 5 1:255-256, 1979.
  3. Chang IL, Meluwis H, Bleyaert A, Babinski M, Retruscak 1. Severe abdominal distention following id ventilation during general anesthesia. Anesthesiology 49:216, 19 7 B.