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Introduction: Superimposed high-frequency jet ventilation (SHFJV) is a new type of jet ventilation that simultaneously uses high- and low-frequency types of jet ventilation. We compared SHFJV with the conventional high-frequency jet ventilation (CHFJV) in interventional bronchoscopy in terms of safety and effectiveness. Methods : A multi-centre prospective random single-blind clinical trial was conducted by three interventional bronchoscopy centres. Patients who underwent diagnostic or therapeutic bronchoscopy under general anaesthesia were admitted and divided into two groups: SHFJV group (trial group) and CHFJV group (control group). PaO2 and PaCO2 were recorded before anaesthesia and during and after the procedure. SpO2 and etCO2 were recorded every 10 min throughout the procedure. Patients were observed until 24 h post-bronchoscopy. Results: Sixty patients were included in the study. Twenty-nine were in the trial group, and 31 were in the control group. Both groups had no significant differences in demographic data. In the control group, the PaO2 measured in the operation was higher than that in the trial group (p = 0.023). The values of etCO2 in the control group were more dispersed than those of the trial group. When the procedure time was over 90 minutes, the etCO2 in the control group significantly increased (p = 0.01), while the etCO2 in trial group remained stable (p = 0.594). There were more patients with PaCO2 ≥ 50 mmHg during the procedure in the control group than in the trial group (p = 0.042). Conclusion : SHFJV is effective and safe in interventional bronchoscopy. It may provide more effective and stabilised ventilation than CHFJV in cases with long procedure times., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Patent ductus arteriosus (PDA) treatment is typically pharmacologic, but if unsuccessful, surgical ligation is commonly performed. High-frequency jet ventilation (HFJV) is used at the University of Iowa Stead Family Children's Hospital for extremely low birth weight infants. Historically, neonates requiring PDA ligation were temporarily transferred to conventional ventilation (CV) prior to surgery., Objective: The objective of this study was to determine whether conversion was necessary., Methods: This retrospective cohort analysis examined outcomes following PDA ligation from 2014 to 2016 at the University of Iowa's Stead Family Children's Hospital. Infants who were transferred to CV prior to surgery and returned to HFJV postprocedure are referred to as the CV cohort. The HFJV cohort infants remained on HFJV throughout., Results: We found no significant increases in morbidity or mortality with the use of intraoperative HFJV and potentially show some benefit through greater reduction in serum CO 2 ., Conclusions: Mode of ventilation during PDA ligation does not affect surgical morbidity or mortality or short-term clinical outcomes. Conversion to CV from HFJV is not necessary.

Intensive care unit patients are at particular risk of respiratory failure after major abdominal surgery. Non-invasive ventilation or application of continuous positive airway pressure through a face mask may stabilise respiratory function and avoid the need for endotracheal re-intubation. However; there are various contraindications to non-invasive ventilation and/or tracheal re-intubation, such as recent oesophageal anastomosis, anastomotic leakage or tracheal stenting for tracheo-oesophageal fistula. A specific management strategy consisting of continuous intratracheal jet ventilation to support spontaneous respiratory function is described in two patients with contraindications to non-invasive ventilation or mask continuous positive airway pressure after major oesophageal surgery.

We present the use of transtracheal jet ventilation in two uncooperative patients with a difficult airway. Although transtracheal jet ventilation is considered as a last resort option in the difficult airway algorithm, its use can be a valuable tool in selected difficult airway situations. Transtracheal jet ventilation can effectively maintain arterial oxygenation and provide extra time for attempts to intubate the trachea, either directly or fibreoptically.

Simple manual ventilation facilitates removal of intra-alveolar accumulations. High-frequency jet ventilation can be performed through a narrow lumen like that of a fibreoptic bronchoscope. Accordingly, we expected that high frequency jet ventilation through a fibreoptic bronchoscope channel would facilitate lung lavage, and we developed a new bronchoalveolar lavage system, in which high-frequency jet ventilation through the channel of a fibreoptic bronchoscope was combined with conventional bronchoalveolar lavage. We describe a case in which this new lavage system, unlike conventional bronchoalveolar lavage, successfully removed the lipid material in the alveoli associated with pulmonary alveolar proteinosis.

We carried out an audit of needle cricothyroidotomy and transtracheal ventilation used during anaesthesia for elective endolaryngeal surgery. The data on 90 consecutive procedures was collected over two years. Patients were anaesthetized using a total intravenous technique. An intravenous cannula or Tuohy needle was placed through the cricothyroid membrane and the patient was ventilated via the cannula using high frequency jet ventilation. Technical details of the procedure and any perioperative complications were recorded. There were 12 complications in total. Only three of these were clearly related to the cricothyroid puncture, i.e., one minor bleed and two cases of limited local surgical emphysema. All complications were minor and resolved without sequelae.

A method of jet ventilation during total laryngectomy is described. During the construction of the terminal tracheostomy, a small metal tube is used, instead of the traditional tracheostomy tube, to provide intermittent jet ventilation down the distal trachea. A pressure regulator is also employed to choose a driving pressure best suited to the chest and lung compliance of each patient. Excellent surgical access for tracheo-cutaneous anastomosis is achieved. Satisfactory ventilation during the jet period is also confirmed by unaltered PaCO2 and increased PaO2 levels. The use of pulse oximetry as a non-invasive and continuous monitor of arterial oxygenation is a simple alternative to arterial blood sampling.