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The narrow airway: from high-frequency jet ventilation to flow-controlled ventilation
Alberto Grassetto1, Joshua H Atkins2
1Department of Anesthesia and Intensive Care, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Current Opinion in Anaesthesiology
|August 5, 2025
Summary
Flow-controlled ventilation (FCV) shows promise for managing narrow airways during surgery, offering better surgical access and safety than high-frequency jet ventilation (HFJV). Further trials are needed to confirm its benefits.
Area of Science:
- Anesthesiology
- Respiratory Physiology
- Surgical Airway Management
Background:
- Managing narrow airways during surgery presents significant challenges for gas exchange and surgical access.
- High-frequency jet ventilation (HFJV) is an established technique for such scenarios.
Purpose of the Study:
- To compare high-frequency jet ventilation (HFJV) with flow-controlled ventilation (FCV) for upper airway surgery.
- To synthesize current understanding of ventilation techniques in challenging airway cases.
Main Methods:
- Literature review synthesizing current understanding of HFJV and FCV.
- Comparison of techniques based on clinical experience and studies.
Main Results:
- Flow-controlled ventilation (FCV), especially with a narrow-bore cuffed tube, may improve surgical access, visibility, ventilation, and safety.
- FCV shows potential advantages in laryngeal and tracheal surgery for patients with significant airway narrowing.
Conclusions:
- While HFJV is valuable, FCV offers potential advantages in airway management and protection.
- Further prospective trials are necessary to fully assess FCV's safety and efficacy compared to HFJV in upper airway surgery.
Keywords:
airway managementflow-controlled ventilationhigh-frequency jet ventilationlaryngotracheal surgerytracheal stenosisMore Related Videos
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