Modes of mechanical ventilation

Jet ventilation is a special form of ventilation for surgical interventions in the respiratory tract in anesthesia. It refers to the intermittent application of respiratory gas under high pressure through thin and non-blocking lines in the outwardly open airway. The main difference to conventional ventilation lies in the fact that in the jet ventilation of the dead space plays a far smaller role and is not based on alveolar ventilation. Gas exchange is the result of several to addierender and supporting mechanisms that together lead to a continuous leaching of the lungs with fresh ( oxygen-rich ) gas and for the removal of spent ( carbon dioxide- rich and oxygen-poor ) gas.

Because relatively large volumes of gas to flow through narrow-bore pipes and nozzles, the gas particles are accelerated at very high velocities. This gives rise to the characteristic flow noise, which justify the use of the " jet" concept. It has become common in <1 Hz for low and Normofrequenter jet ventilation ( NFJV ) and at 1-10 Hz high-frequency jet ventilation ( HFJV ) to speak.

The operative indication area of HFJV is limited at present mainly due to diagnostic and surgical procedures on larynx, airways and lungs. It is made ​​by endoscopy diagnostic and surgical interventions with a rigid bronchoscope, Stützlaryngoskop, various optics and binocular microscope.

Based on these operations is the same microlaryngoscopy by Kleinsasser instrument or variations with exposure of the surgical field. Here enter both microsurgical techniques and Laserresektionen used. Deeper lesions are in a direct way ( transcutaneously ) addressed, as in the case of the trachea or Bronchusresektionen, sculptures or operations on the tracheostoma. The combinations of the two approaches occurs in the import and explantation of laryngotracheal stents as well as voice prostheses.