Transtracheal jet ventilation

Transtracheal jet ventilation (TTJV) is a method of lung ventilation via a narrow-bore catheter placed percutaneously into the trachea, bypassing the upper airway and glottis. A pressurized jet of oxygen, that entrains air, is delivered to the lungs. This technique can be utilized in both elective and emergency situations. However, the Difficult Airway Society (DAS) recommends that the use of TTJV in ‘can't intubate, can't oxygenate’ (CICO) situations is restricted to experienced clinicians who regularly use the technique in their routine clinical practice. Instead, DAS advocate that a surgical approach is the default technique for most clinicians in CICO situations, due to the high rate of failure associated with TTJV in the emergency setting. In patients with anticipated difficult airway management, the prophylactic insertion of a transtracheal catheter is well described. If successful, this technique allows for continued oxygenation of the patient while attempts are made to secure a definitive airway. This article outlines the indications for TTJV and explains the physiological principles behind its mechanism of action. The equipment required, recommended technique, and potential complications are also described.

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