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  • Title: Two-lung high-frequency jet ventilation as an alternative ventilation technique during transthoracic esophagectomy.
    Author: Buise M, van Bommel J, van Genderen M, Tilanus H, van Zundert A, Gommers D.
    Journal: J Cardiothorac Vasc Anesth; 2009 Aug; 23(4):509-12. PubMed ID: 19246214.
    Abstract:
    OBJECTIVE: The aim of this study was to evaluate two-lung high-frequency jet ventilation during esophagectomy and evaluate the influence of high-frequency jet ventilation on pulmonary complications as compared with one-lung ventilation. DESIGN: A retrospective study. SETTINGS: A single-center study in a university hospital. PARTICIPANTS: The authors analyzed the data of patients who had undergone an elective esophagectomy by transthoracic esophagectomy between January 2000 and December 2006. INTERVENTION: The patients had undergone a cervicothoracoabdominal subtotal esophagectomy via a right-sided thoracotomy. Patients with high-frequency jet ventilation were intubated with a single-lumen endotracheal tube, and an oxygen insufflation catheter was placed inside the endotracheal tube and connected to a high-frequency jet ventilator. MEASUREMENTS AND MAIN RESULTS: Eighty-seven patients were enrolled, 30 with high-frequency jet ventilation and 57 with 1-lung ventilation. Both groups were adequately oxygenated, but patients in the one-lung ventilation group had a higher PaCO2 (42.75 +/- 7.5 mm Hg) compared with that for the high-frequency jet ventilation group (35.25 +/- 8.25 mm Hg) (p < 0.05). There were no differences in postoperative respiratory complications between the 2 groups. Mean blood loss was significantly lower for patients in the high-frequency jet ventilation group (1,243 +/- 787 mL). CONCLUSIONS: High-frequency jet ventilation to 2 lungs, using a single-lumen tube, is a safe and adequate ventilation technique for use during esophagectomy. High-frequency jet ventilation had no influence on the incidence of postoperative pulmonary complications but reduced perioperative blood loss and led to a decreased need for fluid replacement.
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