Anesthetic considerations for automated high-frequency jet ventilation during electromagnetic navigation bronchoscopy

Roger Masters, Rabih Bechara, Neil R. Seeley, Christopher Parks, Zachary D. Moore

Research output: Contribution to journalArticlepeer-review

Abstract

Newly advanced diagnostic bronchoscopic procedures, such as electromagnetic navigation bronchoscopy using navigation system technology (superDimension, Medtronic), provides computed tomography referenced and computerized 3-dimensional imaging. To increase accuracy and higher diagnostic biopsy yield, electromagnetic navigation bronchoscopy necessitates special anesthetic and ventilation techniques providing the interventional pulmonologist minimal respiratory lung motion. This anesthetic meets 2 important goals by limiting almost all interference from diaphragmatic and lung movement while allowing the anesthesia provider to achieve hands-free management. Proposed here is an anesthetic ventilation technique by automated high-frequency jet ventilation (HFJV) via double-lumen micro jet endotracheal tubes. This ventilation technique delivers consistent very low tidal volumes. Automated HFJV provides the pulmonologist the advantage of more accurate navigation and target alignment in this Global Positioning System–guided biopsy procedure. The technique offers essentially no chest motion, without interrupting ventilation. Additionally, HFJV allows the anesthetist better availability to attend to total intravenous anesthesia, adjustments, and interventions. The intention of this article is to detail an anesthetic method that provides a hands-free technique that requires only one anesthesia provider.

Original languageEnglish (US)
Pages (from-to)101-106
Number of pages6
JournalAANA journal
Volume88
Issue number2
StatePublished - Apr 1 2020

Keywords

  • Electromagnetic navigation bronchoscopy
  • High-frequency jet ventilation
  • SuperDimension
  • Total intravenous anesthesia

ASJC Scopus subject areas

  • Medical–Surgical
  • Advanced and Specialized Nursing
  • Anesthesiology and Pain Medicine

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