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Low Pressure Low Frequency Jet Ventilation: Techniques, Safety and Complications
Calvin W Myint1, Stephanie E Teng2, Jennifer J Butler3
1Ear Nose and Throat Specialists, Conyers, GA, USA.
Low pressure low frequency jet ventilation (LPLFJV) is a safe and effective technique for microlaryngeal surgeries, with low complication rates. Higher BMI was associated with increased need for intubation during LPLFJV procedures.
Area of Science:
- Otolaryngology
- Anesthesiology
- Respiratory Medicine
Background:
- Manual jet ventilation is a specialized technique with limited availability due to unfamiliarity and perceived risks.
- Low pressure low frequency jet ventilation (LPLFJV) offers an alternative for oxygenation and ventilation during specific procedures.
Purpose of the Study:
- To review a 15-year experience with LPLFJV at a single center.
- To assess the safety and efficacy of LPLFJV in microlaryngeal surgeries.
- To identify factors associated with complications during LPLFJV.
Main Methods:
- Retrospective review of 891 microlaryngeal surgeries performed between 2005 and 2019 using LPLFJV.
- Data collection included patient demographics, surgery type, and complications.
- Statistical analysis using Fisher exact test, Chi square, and t-test.
Main Results:
- LPLFJV was used in 457 patients for 891 microlaryngeal surgeries (voice disorders, lesions, airway stenosis).
- Peak jet pressures did not exceed 20 psi, with average pressures around 14.9 psi.
- Oxygen saturation averaged 95% ± 0.6%. Intubation was required in 17% of cases, significantly longer for those intubated (P < .001).
- Intubation need correlated strongly with BMI (7% normal weight to 37% morbidly obese).
- Three patients had post-operative respiratory distress; two required intubation.
Conclusions:
- LPLFJV, with intermittent endotracheal intubation, is a safe and effective intraoperative oxygenation and ventilation method for various laryngeal procedures.
- The technique is well-tolerated, with minimal complications observed.
- BMI is a significant predictor for the need for intubation during LPLFJV.
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