Ventilation through small-bore airways in children by implementing active expiration

M. de Wolf*, D. Enk, N. Jagannathan

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

1 Citation (Web of Science)

Abstract

Management of narrowed airways can be challenging, especially in the smallest patients. This educational review focusses on active expiration through small-bore airways with the Ventrain (Ventinova Medical, Eindhoven, The Netherlands). Manual ventilation with the Ventrain establishes inspiratory and expiratory flow control: By setting an appropriate flow, the volume of gas insufflated over time can be controlled and expiration through a small-bore airway is expedited by jet-flow generated suction, coined "expiratory ventilation assistance" (EVA). This overcomes the inherent risks of emergency jet ventilation especially in pediatric airway emergencies. Active expiration by EVA has been clinically introduced to turn a "straw in the airway" into a lifesaver allowing not only for quick and reliable reoxygenation but also adequate ventilation. As well as managing airway emergencies, ventilating through small-bore airways by applying EVA implements new options for pediatric airway management in elective interventional procedures. Safe application of EVA demands a thorough understanding of the required equipment, the principle and function of the Ventrain, technical prerequisites, clinical safety measures, and, most importantly, appropriate training.
Original languageEnglish
Pages (from-to)312-320
Number of pages9
JournalPediatric Anesthesia
Volume32
Issue number2
Early online date22 Dec 2021
DOIs
Publication statusPublished - Feb 2022

Keywords

  • airway
  • PICU
  • critical care
  • airway devices
  • devices
  • equipment
  • techniques
  • EMERGENCY VENTILATION
  • EXCHANGE CATHETER
  • OXYGEN SOURCES
  • VENTRAIN
  • PERFORMANCE
  • MANAGEMENT
  • IMPACT

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