Alternative Ventilatory Techniques

Abstract

Most patients undergoing thoracic surgical procedures suffer from some degree of pulmonary disease which impacts their ventilatory management. Traditional modes of positive pressure mechanical ventilation are familiar to the general practitioner (Box 11-1) (Fig 11-1) and have been well reviewed (1). Variations on these common modes, dictated by pathophysiology (e.g., longer expiratory time for obstructive pulmonary disease, etc.) should also be familiar (2). The focus of this chapter will be alternative ventilatory techniques that may be necessary during specific thoracic surgical procedures or situations, when traditional ventilatory techniques are inadequate. Such alternative techniques (e.g., jet ventilation, high frequency ventilation (HFV), etc.) may be used as the primary mode of ventilation, or as an adjunct in various thoracic surgical situations.