Posthumus, I. (Iris) (2014) Toepasbaarheid van geavanceerde high frequency jet ventilation bij ingrepen van de larynx, trachea & hoofdbronchi. thesis, Medicine.
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Abstract
Background: Endoscopic surgeries of the larynx, trachea and main bronchi require an optimal cooperation between the laryngologist and anesthesiologist. An unimpeded view of the larynx is important, however, ventilating the patient should in no way be impaired. Advanced requency jet ventilation (GJV) via a jet modified laryngoscope or bronchoscope seems promising. Two nozzles are integrated in the wall of the specially designed laryngoscope or bronchoscope. Therefore, use of an endotracheale tube, catheter or needle is not needed. Due to the venturi effect adequate ventilation can be ensured. The primary goal of this study was to evaluate the feasibility of advanced GJV via a jet modified laryngoscope or bronchoscope during endoscopic surgeries of the larynx, trachea and main bronchi. The secondary goal was to contemplate possible indications, contraindications and disadvantages of GJV. Furthermore, we considered whether in some cases tracheotomy was prevented, due to the use of GJV. Methods: A total of 172 procedures were performed with the intention to use GJV via a jet modified laryngoscope or bronchoscope. The primary outcome measure was the need for conversion to conventional ventilation (CB) via an endotracheale tube (et-CB) or conventional HFJV via a jetcatheter (CJV). The secondary outcome measures were the anatomical location of the disease, procedure, comorbidities, BMI, ASA classification, SpO2, need for reoxygenation, complications, and the duration of the GJV procedure. Results: GJV was successful in 161 procedures (93.6%). Conversion to et-CB or CJV did not significantly occur more between the different anatomical locations, procedures, and comorbidities. Also no statistic significant differences in BMI between the two groups were found (p= 0.8). There was no affinity between gender and conversion or ASA classification and conversion (p= 0.086 and p= 0.57). There were no complications. In some cases a tracheotomy was prevented. Conclusion: GJV via a laryngoscope or bronchoscope is applicable in endoscopic surgeries of the larynx, trachea and main bronchi. There was no influence of other factors on the success rate of GJV; therefore GJV can be widely applied.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Eindhoven, drs. G.B. and Dikkers, dr. and Wietasch, dr. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/369 |
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