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Modified Jet Ventilation during Total Laryngectomy: A Prospective Study using Pulse Oximetry and a Pressure Regulator

A method of jet ventilation during total laryngectomy is described. During the construction of the terminal tracheostomy, a small metal tube is used, instead of the traditional tracheostomy tube, to provide intermittent jet ventilation down the distal trachea. A pressure regulator is also employed to choose a driving pressure best suited to the chest and lung compliance of each patient. Excellent surgical access for tracheo-cutaneous anastomosis is achieved. Satisfactory ventilation during the jet period is also confirmed by unaltered Paco2 and increased Pao2 levels. The use of pulse oximetry as a non-invasive and continuous monitor of arterial oxygenation is a simple alternative to arterial blood sampling.