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Year : 2018  |  Volume : 62  |  Issue : 2  |  Page : 152  

Jet insufflation options for the cannot intubate–cannot ventilate situation

Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba, Canada

Date of Web Publication12-Feb-2018

Correspondence Address:
Dr. Hilary P Grocott
Department of Anesthesia, University of Manitoba, CR3008 - 369 Tache Avenue, Winnipeg, R2H 2A6, Manitoba
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ija.IJA_724_17

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How to cite this article:
Grocott HP. Jet insufflation options for the cannot intubate–cannot ventilate situation. Indian J Anaesth 2018;62:152

How to cite this URL:
Grocott HP. Jet insufflation options for the cannot intubate–cannot ventilate situation. Indian J Anaesth [serial online] 2018 [cited 2021 Jan 19];62:152. Available from: https://www.ijaweb.org/text.asp?2018/62/2/152/225226


The recent letter by Kulkarni et al.[1] outlining the jet insufflation jugaad that was derived from a Jackson-Rees circuit, a 4 mm ID endotracheal tube connector, and Luer-lock venous extension tubing, offers a potentially viable alternative to commercially available jet ventilation devices such as the Enk Oxygen Flow Modulator (Cook Inc., Bloomington, IN, USA), the Rapid O2™ Insufflator (Meditech Systems Ltd, Shaftesbury, UK) and the Manujet III™ (VBM, Medizintechnik GmBH, Sula and Neckar, Germany) for use in cannot intubate–cannot ventilate situations in paediatric patients. Indeed, the authors' improvised insufflator solution that offers both jet inspiration and active expiration exploits the Hagen–Poiseuille law in a very similar fashion to another relatively new commercially available device, the Ventrain ® (Ventinova Medical B. V., Eindhoven, Netherlands).[2] This device has similarly been shown to allow both inspiration and active expiration when used with both short and long small-bore airway cannulae.[3] The Ventrain device is a portable, easy to use, light weight, stand-alone high-pressure injector that uses up to 15 L/min in oxygen flow. Importantly, it has also withstood the evaluative rigor of medical equipment regulatory agencies making it potentially safer than the improvised device suggested by Kulkarni et al. That said, I congratulate these authors on their improvisation and ingenuity, as they appear to have independently validated and partially replicated the work that had been accomplished with the Ventrain.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Kulkarni KS, Dave NM, Karnik PP, Garasia M. Jet insufflator for cannot intubate cannot ventilate situation. An Indian Jugaad. Indian J Anaesth 2017;61:941-2.  Back to cited text no. 1
[PUBMED]  [Full text]  
Lang SA. Emergency airway management: What are the roles for surgical cricothyroidotomy and the Ventrain(®) device? Can J Anaesth 2016;63:997-8.  Back to cited text no. 2
de Wolf MW, Gottschall R, Preussler NP, Paxian M, Enk D. Emergency ventilation with the Ventrain ® through an airway exchange catheter in a porcine model of complete upper airway obstruction. Can J Anaesth 2017;64:37-44.  Back to cited text no. 3


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