La jet-ventilation pour les nuls

Jet-ventilation is a very high velocity, very low airway pressure ventilation. Why is barotrauma the major risk of complication of jet-ventilation? Because air exsufflation is purely passive, depending on 3 parameters: (1) the patient's physiologic characteristics (lung elastic recoil strength, lung compliance), (2) ventilatory parameters (frequency, expiratory time, intratracheal pressure monitoring), (3) the quality of anesthetic management (airway permeability, glottis immobility). Gas exsufflation is only possible through the open upper airway and always beside and not through the jet canula (physically impossible!). Jet-ventilation is a mandatory technique in endoscopic ENT procedures and during difficult airway management; it has found new applications in CT-scanner radiofrequency treatment of peri-diaphragmatic lesions. On the other hand each anesthesiologist should be familiar with the transtracheal canulation for emergency oxygenation. In addition to workshop's participation, the elective practice of jet-ventilation in ENT surgery is the best way to become familiar with this technique.