Modified jet ventilation during total laryngectomy: A prospective study using pulse oximetry and a pressure regulator

Abstract

A method of jet ventilation during total laryngectomy is described. During the construction of the terminal tracheostomy, a small metal tube is used, instead of the traditional tracheostomy tube, to provide intermittent jet ventilation down the distal trachea. A pressure regulator is also employed to choose a driving pressure best suited to the chest and lung compliance of each patient. Excellent surgical access for tracheocutaneous anastomosis is achieved. Satisfactory ventilation during the jet period is also confirmed by unaltered P(a)CO2 and increased P(a)O2 levels. The use of pulse oximetry as a non-invasive and continuous monitor of arterial oxygenation is a simple alternative to arterial blood sampling.