Transtracheal jet ventilation in the “can´t ventilate, can´t oxygenate” emergency: a systematic review

Abstract

Transtracheal jet ventilation consists of the introduction of oxygen under pressure through a narrow cricothyroidotomy cannula. Although it is sometimes used during elective head and neck surgeries, its use as a salvage procedure in airway management has also been described. It is included in the DAS guidelines, although limited to professionals with experience in this technique (as in the Canadian guidelines). It is also included in the ASA airway management algorithms.

Some studies suggest a high incidence of failure and barotrauma with the use of transtracheal jet ventilation, so despite being included in numerous guidelines, the benefit of its use is controversial. For this reason, the results of clinical practice are analyzed here by means of a systematic review, trying to determine as the main objective the incidence of complications during its use in the “non-intubable, non-ventilable” situation. The results are compared with the same emergency situations in which this technique was not used.

Complications have been defined as failure of the technique, the appearance of barotrauma (including subcutaneous emphysema) or miscellaneous (bleeding, CRP).