Minitracheostomy: a new delivery system for jet ventilation

Seventeen patients with respiratory failure from a variety of causes have been treated by high-frequency jet ventilation, delivered by a specially designed Y connector and a standard minitracheostomy tube, for periods ranging from 12 hours to 14 days. This percutaneous system provides access for full ventilatory support and tracheobronchial suction, but without the need for a cuffed endotracheal tube or sedation. Patients can eat, drink, and talk during ventilation. Ten of the patients were male and ages ranged from 31 to 77 years. Ventilation was satisfactory in 16 patients and unsatisfactory in one, who had also been difficult to manage on conventional ventilation. Thirteen patients resumed full spontaneous respiration and four died of their underlying disease while still being supported with a ventilator. These results suggest that the combination of minitracheostomy and high-frequency jet ventilation may offer significant advantages in the management of some patients with respiratory failure.