Transtracheal jet ventilation in a porcine model

Hypoxemia is a frequent event during difficult airway management. We propose to use transtracheal jet ventilation (TTJV) early during the management of complex difficult airway scenarios. The objective of this porcine study is to highlight the benefit of oxygenation via prophylactic TTJV. Eighteen pigs (Sus scrofa) were divided into two equal groups. In Group A, pigs were anesthetized and no lung ventilation was conducted following administration of succinylcholine and prior to tracheal intubation. Group B, after induction of anesthesia, received transtracheal ventilation using 100% oxygen. In both groups intubation was performed after waiting 90 seconds. All intubations were achieved in less than 30 seconds. Postintubation arterial blood gases demonstrated significant hypoxemia in Group A (PaO 2 22.6 + 5.8 mm Hg), while in Group B oxygenation substantially improved (PaO 2 470.3 + 17.0 mm Hg). The arterial CO 2 retention was associated with mild respiratory acidosis (pH 7.26 ± 0.05) in Group A only. These findings prove that prophylactic TTJV can improve oxygenation and allow extra time for definitive management of difficult airway. RYAN MCHUGH • MATTHEW KUMAR •