Percutaneous transcricoid jet ventilation compared with surgical cricothyroidotomy in a sheep airway salvage model

Resuscitation
Seth ManoachRichard Sinert

Abstract

We developed a large animal model of the "cannot intubate/cannot ventilate" (CNI/V) scenario to compare percutaneous transcricoid manual jet ventilation (MJV) with surgical cricothyroidotomy (SC). Twelve sheep weighing 40-80 kg were assigned to MJV or SC groups. After sedation, intubation, and line placement, CNI/V was simulated by removing the tracheal tube and inducing paralysis with vecuronium. When SaO2 reached 80% (t=0), MJV catheter insertion or SC was initiated. Upon successful airway placement, ventilation began using 100% oxygen at 20 breaths/min. MJV was administered at 50 psi. HR, BP, SaO2, pH, PCO2, and PO2 were recorded at t=0, 30, 60, 90, 120, 150, 180, 300, 600, and 1200 s. Data were reported as mean+/-S.E.M. over the whole observation period. Baseline values were compared using Student's t-tests. Repeated-values ANOVA was used for post-procedure group comparisons. Statistical tests were two-tailed and alpha was set at 0.05. Body weights were not significantly (P=0.08) different between MJV (65+/-6 kg) and SC (52+/-3 kg) groups. Baseline respiratory and hemodynamic variables were also not significantly different. Median procedure time for MJV (20 s) and SC (24 s) was not significantly (P=0.69) different. Post-pro...Continue Reading

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Citations

Mar 5, 2014·Pediatric Emergency Care·Jannet J Lee-Jayaram, Loren G Yamamoto
Apr 3, 2012·The American Journal of Emergency Medicine·Ivan MuradThomas V Bataglia
Dec 9, 2008·Emergency Medicine Clinics of North America·Sharon Elizabeth Mace, Nazeema Khan
Dec 7, 2011·Anaesthesia·A E Hamaekers, J J Henderson
Oct 12, 2020·Anaesthesia Critical Care & Pain Medicine·Corinne Lejus-BourdeauVincent Pichenot
Feb 10, 2010·Anesthesia and Analgesia·Nazar SalahConan McCaul

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