Abstract

Objective: This narrative review seeks to examine the fundamental mechanisms, optimal settings, current applications, and emerging indications of jet ventilation. This review is focused on jet ventilation in interventional procedures both within and outside the operating theatre, through a critical analysis of existing literature.

Background: Jet ventilation is primarily utilized in otolaryngology (ENT) surgical procedures, particularly those involving the larynx or trachea. It allows for an unobstructed operating field by eliminating the need of a conventional endotracheal tube. Because of the minimal thoracic expansion it generates, jet ventilation is now used in other fields such as interventional radiology and electrophysiology. Despite its benefits, this technique carries risks such as barotrauma, hypoventilation, hypercapnia, and catheter misplacement. Expertise and a thorough understanding of its principles are therefore essential for its use.

Methods: A literature search was conducted in October 2024 using the PubMed Database. Additional search es were carried out in Google Scholar. Main keywords were combine using the Boolean equations. This narrative study does not aim to be as methodologically comprehensive as a systematic review. The selection of articles is influenced by clinical relevance. However, it offers a critical overview of current practices and future prospects for jet ventilation. This article respect the Scale for the quality Assessment of Narrative Review Articles (SANRA).

Results: Fifty-five publications from 1956 to 2024 were selected for the review. Only three of these articles were published before the year 2000. A thematic analysis was used to structure the results. The use of high-frequency jet ventilation is validated in ear, nose and throat (ENT) surgery, interventional pulmonology, and has its place in emergency situations. It can be used in both adults and children. More recently, its use in interventional radiology, electrophysiology, and lithotripsy has been studied and appears to show certain advantages. The complications related to the use of jet ventilation are generally associated with a lack of experience from the teams.

Conclusions: Jet ventilation is a critical modality in certain clinical settings, particularly within anesthesia for upper airway procedures, laryngeal surgery, bronchoscopy, or when surgical access necessitates an unobstructed operating field. The principal benefits of jet ventilation include preserving excellent operative visibility, minimizing thoracic movement, and frequently ensuring adequate oxygenation despite low tidal volumes. This technique necessitates specialized expertise and diligent monitoring due to its limitations, such as the risk of barotrauma or CO2 accumulation. Further research, including comprehensive comparative studies, is necessary to more precisely delineate its indications, contraindications, and long-term effects, particularly in emerging fields such as interventional radiology, electrophysiology, and lithotripsy.