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Jet ventilation in obese patients undergoing airway surgery for subglottic and tracheal stenosis
Ramez Philips1, Brad deSilva2, Laura Matrka2
1Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Objectives/Hypothesis:
To assess the feasibility of jet ventilation in obese patients and to compare complications of jet ventilation in obese and nonobese patients.
Study Design:
Retrospective review of medical records.
Methods:
We reviewed 46 patient charts (70 procedures) with the diagnosis of tracheal or subglottic stenosis who underwent endoscopic surgery with jet ventilation between March 2014 and January 2017. Adequacy of jet ventilation was assessed by chest rise, avoidance of endotracheal intubation, and length of case and ventilation. Records were reviewed for demographic details, anesthesia records, and complications.
Results:
In 29/70 (41.4%) of cases, patients were obese; in 9/29 (31.0%) of these cases, patients were morbidly obese. Jet ventilation was successful in 28/29 (97%) of obese cases. In 1/29 (3.4%) of cases, the patient required alternative airway management. There were no significant differences between obese and nonobese patients in chest rise, need for endotracheal intubation, and length of surgery or ventilation (P > .05). There were 2/29 (6.9%) cases of intra- and postoperative complications including laryngospasm (1/29, 3.4%) and tachycardia (1/29, 3.4%). Rate of complications did not differ between obese and nonobese patients (P = .178).
Conclusions:
Jet ventilation in obese patients can be done successfully, and complications are similar between obese patients and nonobese patients.
Level Of Evidence:
4. Laryngoscope, 1887-1892, 2018.
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