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KMID : 0356019890040020037
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Koean Jounral of Critical Care Medicine
1989 Volume.4 No. 2 p.37 ~ p.43
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High Frequency Jet Ventilation in Tracheal Tumor Surgery
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Abstract
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A 38-year old male patient underwent tracheal reconstruction because of a tracheal tumor. A CT scan showed that the mass was located 5cm above the carina, the size was 2×1.5cm, and there was a 50% narrowing of the stenotic segment. After endotracheal intubation (1.D. 8 mm), a pediatric suction catheter (lenght:40cm, diameter: 2mm) was inserted with a stylet at the side of the tube to pass the stenotic segment with fiberoptic bronchoscopic guidance. Conventional ventilation with an inhalation agent was performed and HFJV was started just prior to the tracheal incision. A driving gas pressure of 1 kg/cm2, respiratory rate of 120/min., I:E ratio fo #1:1. and Fio2, of 1.0 were applied through the suction catheter.
Ten minutes after HFJV, PaCO2, showed 50mmHg. Hypercabia was relieved by increasing the driving gas pressure from 1 kg/cm2 to 1.5 kg/cm, HFJV was performed for one and a half hours. During the procedure, blood gas analyses were perfomed frequently and all results revealed an adequate ventilatory status After completing the end to end anastomosis, conventional ventilation was started until surgery was ended. The patient´s course proceeded uneventfully and he was discharged 13 days after surgery.
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