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BioMed Research International
Volume 2016, Article ID 4234861, 6 pages
http://dx.doi.org/10.1155/2016/4234861
Review Article

Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review

Department of Anesthesiology, Université catholique de Louvain, CHU UCL Namur, Avenue G. Therasse 1, 5530 Yvoir, Belgium

Received 8 July 2016; Revised 19 September 2016; Accepted 5 October 2016

Academic Editor: Yukio Hayashi

Copyright © 2016 Laurie Putz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min−1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation) has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.