SHFJV can be applied via catheters, bronchoscopes, and jet converters. The most common method in the Netherlands is via the laryngoscope used in ENT/Head and Neck surgery. This frequently used form of jet ventilation is suitable for virtually any patient undergoing procedures around the larynx and trachea, from newborns to adults with (severe) obesity. When applying jet ventilation via the laryngoscope, always select the LAR mode on the device before starting. Then, enter the patient’s weight, press “start,” and the device will suggest ventilation settings.
With jet ventilation via the modified jet laryngoscope, you can apply all relevant methods and measurements. The jet laryngoscope is equipped with two jet channels and two measurement channels, which ensures safety. All relevant parameters are measured via these measurement channels on the scope. The normal and high-frequency jets are applied via the two jet channels. The image below shows the structure of such a jet laryngoscope. On one side are the jet stream channels, and on the other side are the monitoring channels for ventilation pressures, FiO2, and EtCO2.
CARL REINER® has been producing laryngoscopes based on the design of Dr. Oskar Kleinsasser since the early 1960s. They began the initial development of modified laryngoscopes in the late 1980s. Many laryngoscopes have since been developed in collaboration with Dr. Aloy, and channels for jet and monitoring have also been applied to the laryngoscopes. This enables continuous monitoring of airway pressure and respiratory gas analysis (including FiO2 and EtCO2) at any time. For pediatric applications, we frequently see the laryngoscopes based on the design of Benjamin Lindholm.
An essential condition for optimal jet ventilation is the entrainment of the aspirated ambient air. The amount of entrainment is partly determined by the emission pressure of the jet stream and the location in the scope where the jet stream exits. Precise research (see figure below) into the correct position of the jet supply and monitoring leads to optimal jet ventilation via the laryngoscope.
Due to this precise adjustment of the various channels, tailored to the jet laryngoscope being used, SHFJV is well-suited for procedures of the larynx and trachea in all age categories. Proper positioning of the jet laryngoscope in front of the entrance to the trachea is also important to achieve good jet ventilation. If a significant portion flows out beside the trachea, this directly affects the ventilation.
CARL REINER® supplies many Jet Laryngoscopes based on the laryngoscopes of KARL STORZ® and more. In this brochure, you can find all possible jet laryngoscopes, for both adults and children, that are available for Jet ventilation with the TwinStream™.
