[Bilateral pneumothorax due to jet ventilation, a case report]

ABSTRACT

Jet ventilation is one of the procedures that do not need intubation. Jet ventilation is used in difficult intubation, diagnostic laryngoscopy and micro laryngeal surgery, adult respiratory distress syndrome and bronchopleural fistulas. Jet ventilation has done by a thin cannula such as angiocath from oral or nasal route or cricothyroid membrane. Respiratory rate is 10-15/min in low frequency or 100-200/min in high frequency and tidal volume is 1-2 cc/kg to 5-10 cc/kg and O[2] pressure is 15-50 psi with high flow. Major complication is this procedure is cannula kink, hyperinflation, pneumothorax and sub cutaneous emphysema. In this patients for good exposure of the layrnx and immobility of the vocal cords, a nelaton cath was used from oral route into trachea and jet ventilation was done with 10-15/ min and 5cc/kg. Total IV anesthesia was done. Air-trapping and bilateral pneumothorax was caused due to pharyngeal obstruction and hemorrhage. Then the problem was resolved rapidly with bilateral chest tubes. The patient discharges after 3 days. Therefore when this procedure was used, we must be careful for expiration. Airway obstruction is treated rapidly and jet ventilation is stopped soon