Upper Airway Surgery

During upper airway surgery ventilation may remain uneventful as long as the airway is open. Unfortunately, typical complications like difficult airways or (suddenly) obstructed airways may occur, leaving the use of an endotracheal small bore catheter or even cricothyrotomy as a final solution for ventilation. In combination with conventional jet ventilation this severely increases the risk on barotrauma.

 

EVA for ventilating through small bore lumens

The Expiratory Ventilation Assistance (EVA) technology, facilitating expiration, enables full ventilation through small bore lumens in cases involving critically obstructed upper airways and it strongly reduces the risk on barotrauma. Moreover, it creates additional working space for the surgeon during an upper airway surgery, for example a tumor resection.


The below video will give you an example hereof:
 

Rosenblatt Ventrain use from Ventinova Medical on YouTube.


Ventrain for different Upper Airway Surgery scenarios

Our ventilation device Ventrain, which contains the patented EVA technology, is able to provide full ventilation of a difficult airway during upper airway surgery. Since Ventrain can be connected to both transtracheal catheters and small bore endotracheal catheters, it can be used in different scenarios:

 

The following examples are encapsulated in the diagram above.

  • Open airway: The airway is initially open and a small bore endotracheal tube is used to provide more working space; however during the surgery the airway becomes increasingly obstructed. The selected ventilation device (e.g. automatic jet ventilator) no longer provides sufficient ventilation due to the increasing lung pressure. Switching to Ventrain will provide full ventilation and restore blood-gas levels and lung pressure.
  • Difficult airway: The airway is partially occluded, disabling intubation with a large bore tube (ID >6 mm). Instead a long thin endotracheal tube (ID 2-3 mm), or alternatively a transtracheal catheter (ID 2 mm), is used in combination with (automated) jet ventilation, with concomitant risk on high lung pressure, or in combination with manual ventilation by Ventrain, without this increased risk.
  • Obstructed airway: In case of a fully obstructed airway, only Ventrain is able to ventilate through a small bore tube (ID 2-3 mm) or a transtracheal catheter (ID 2 mm) due to its EVA technology, facilitating ventilation.
  • An anticipated difficult airway situation: as a precaution a transtracheal catheter can be placed and in case the airway is occluding Ventrain can be used to ventilate.

 

Advantages of Ventrain during Upper Airway Surgery

Ventilation with Ventrain during upper airway surgery combines the physical advantages of small bore lumens with the ventilation benefits of Ventrain:

  • full ventilation (oxygenation and active CO2 removal);
  • minute volume up to 7 L/min;
  • non vibrating vocal cords;
  • minimally invasive;
  • better view for surgeon;
  • increased surgical space.

 

More information

For more information and user reports, see the following links:

  • Dr. Kalsi case report;
  • Borg PA, Hamaekers AE, Lacko M, Jansen J, Enk D. Ventrain® for ventilation of the lungs. Br J Anaesth. 2012 Nov; 109(5):833-4.
  • Kalkoff M. Ventilation through a small-bore intubating catheter using Ventrain in an elective procedure. Br J Anaesth. Out of the Blue E-letters published 18 December 2012.

 

©2016 Ventrain, Cricath, Tritube, Evone and the EVA technology are registered trademarks of Ventinova Medical B.V. All rights reserved.

Products

  • Now Available! Tritube

    Tritube is an ultra-thin ventilation tube for adult patients. It provides easy access to the airway, a secured airway and a spacious surgical site.

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  • Ventrain

    Ventrain  not only supplies oxygen during the inspiration phase, but also actively removes gas from the lungs with Expiratory Ventilation Assistance.

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  • Cricath

    Cricath is a flexible 2 mm needle catheter for quick and easy cricothyrotomy. A number of smart features result in easier handling and reduced risk of kinking.

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  • Ventrain Emergency Kit

    The Ventrain Emergency Kit contains Ventrain and Cricath in one kit for full ventilation in a ‘Cannot Intubate, Cannot Ventilate’ situation.

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Small Lumen Ventilation

Small Lumen Ventilation

The unique and proprietary Expiratory Ventilation Assistance technology, also known as EVA, actively induces expiration. EVA shortens expiration time, increases the achievable minute volume and reduces the risk of air trapping.

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