Hunsaker mon‐jet tube ventilation: A 15‐year experience
2012; Wiley; Volume: 122; Issue: 10 Linguagem: Inglês
10.1002/lary.23491
ISSN1531-4995
AutoresAmanda Hu, Philip A. Weissbrod, Nicole Maronian, Jennifer K. Hsia, Joanna M. Davies, Gouri K. Sivarajan, Allen D. Hıllel,
Tópico(s)Trauma Management and Diagnosis
ResumoAbstract Objective/Hypothesis: The Hunsaker Mon‐Jet tube (HMJT) (Xomed, Jacksonville, FL) has been used effectively for subglottic ventilation. We previously reported a series of 552 patients over a 10‐year period with no major complications. This is a continuation of that series with an additional 5 years of cases. Study Design: Retrospective consecutive case series. Methods: Patients who were ventilated with the HMJT for microlaryngeal surgery at the University of Washington Medical Center over a 15‐year period (1995–2010) were identified from the Voice Disorders database. Charts were reviewed for demographic data, laryngeal diagnosis, and anesthetic parameters. Main outcome measure was the rate of complications. Results: Fifty‐seven complications occurred in 49 cases out of 839 cases (5.8% complication rate). In descending order, the complications were hypoxia (SpO 2 <90%, n = 30, 3.6%), hypercarbia (end tidal CO 2 of >60 mm Hg, n = 17, 2.0%), airway obstruction (n = 4, 0.5%), barotrauma (n = 2, 0.2%), seeding of blood into trachea (n = 2, 0.2%), submucosal injection of air (n = 1, 0.1%), and mucosal damage (n = 1, 0.1%). Factors associated with complications included high body mass index ( P = .04), American Society of Anesthesiology class III or IV ( P = .01), history of heart disease ( P = .02), history of previous laryngeal surgery ( P = .02), longer duration of case ( P = .006), and laser use ( P = .005). Conclusions: Although subglottic ventilation via an HMJT is a safe alternative to traditional endotracheal intubation in an appropriately selected population, practitioners should remain vigilant about the known complications. Laryngoscope, 2012
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