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Ventilatory Modes01:14

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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
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Ventilation through small-bore airways in children by implementing active expiration.

Michiel de Wolf1, Dietmar Enk2, Narasimhan Jagannathan3

  • 1Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.

Paediatric Anaesthesia
|December 13, 2021
PubMed
Summary

Active expiration using the Ventrain device, or expiratory ventilation assistance (EVA), expedites gas exchange in small airways. This technique offers a safer alternative for pediatric airway emergencies and new options for elective procedures.

Keywords:
airway, PICUcritical care, airway devicesdevicesequipmenttechniques

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Area of Science:

  • Pediatric Pulmonology
  • Respiratory Care
  • Medical Devices

Background:

  • Managing narrowed airways in pediatric patients presents significant challenges.
  • Traditional ventilation methods carry risks, especially in emergency situations involving small airways.

Purpose of the Study:

  • To review the use of the Ventrain device for active expiration through small-bore airways.
  • To highlight the benefits of expiratory ventilation assistance (EVA) in pediatric airway management.

Main Methods:

  • The review focuses on the Ventrain device and its mechanism of expiratory ventilation assistance (EVA).
  • Discussion includes inspiratory and expiratory flow control facilitated by the Ventrain.
  • The review covers clinical applications, safety measures, and training requirements for EVA.

Main Results:

  • The Ventrain enables controlled insufflation and expedited expiration through small airways via jet-flow generated suction (EVA).
  • EVA effectively overcomes risks associated with emergency jet ventilation in pediatric patients.
  • Clinical introduction of EVA transforms management of "straw in the airway" scenarios, enabling reoxygenation and ventilation.

Conclusions:

  • Expiratory ventilation assistance (EVA) with the Ventrain provides a life-saving option for pediatric airway emergencies.
  • EVA offers new possibilities for pediatric airway management during elective interventional procedures.
  • Safe and effective application of EVA requires comprehensive understanding of the device, principles, and proper training.