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Updated: Jul 28, 2026

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Intrapulmonary percussive ventilation via Mini-Trach II in critical care: a case report
Emina Niisato1, Yoshiyuki Hiramoto2, Hitoshi Yamada3
1Department of Anesthesiology and Intensive Care Medicine, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1703, Japan. niisato.e@gmail.com.
Background:
Intrapulmonary percussive ventilation (IPV) facilitates the mobilization and clearance of bronchial secretions. Cricothyroidotomy using a Mini-Trach II device is a minimally invasive method used for secretion clearance. To our knowledge, there are no previous reports regarding IPV combined with Mini-Trach II.
Case Presentation:
An 82-year-old man underwent controlled mechanical ventilation and IPV via an endotracheal tube to treat atelectasis following emergency surgical repair of a traumatic diaphragm laceration. He underwent cricothyroidotomy using Mini-Trach II for ensuring airway management after extubation. On resumption, IPV through a mouthpiece or face mask was unsuccessful owing to air leakage from his mouth. However, IPV via the already inserted Mini-Trach II could deliver the percussion flow and led to a marked improvement in his condition.
Conclusion:
This experience indicates that Mini-Trach II is beneficial as a minimally invasive interface for IPV that can deliver percussion flow efficiently.
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