High pressure percutaneous transtracheal ventilation: The use of large gauge intravenous-type catheters in the totally obstructed airway

Joseph C. Stothert, Mark J. Stout, Lawrence M. Lewis, Raymond M. Keltner

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Percutaneous transtracheal ventilation using a large gauge intravenoustype catheter can be used successfully in the setting of complete upper airway obstruction in animals. In this study, using a large animal model, satisfactory oxygenation and ventilation was achieved by inversely varying the catheter size and the inspiration to expiration ratio (I:E). Specifically, 30 to 63 kg ruminants with an obstructed upper airway were resuscitated for 30 minutes from a hypoxic, hypercarbic, and acidotic state using 12- and 14-gauge catheters connected to a 50 psl oxygen source via a two-way valve with an I:E of 1:4 and 1:9 seconds, respectively. Shorter expiratory time or increased inspiratory time with these intravenous catheters resulted in significant hemodynamic compromise, barotrauma, inadequate carbon dioxide elimination, acidemia, and frequent death.

Original languageEnglish (US)
Pages (from-to)184-189
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume8
Issue number3
DOIs
StatePublished - May 1990

Keywords

  • Percutaneous transtracheal ventilation
  • barotrauma
  • inspiration: expiratory ratio
  • upper airway obstruction

ASJC Scopus subject areas

  • Emergency Medicine

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