High pressure percutaneous transtracheal ventilation: the use of large gauge intravenous-type catheters in the totally obstructed airway

Am J Emerg Med. 1990 May;8(3):184-9. doi: 10.1016/0735-6757(90)90318-t.


Percutaneous transtracheal ventilation using a large gauge intravenous-type catheter can be used successfully in the setting of complete upper airway obstruction in animals. In this study, using a large animal model, satisfactory oxygenation and ventilation was achieved by inversely varying the catheter size and the inspiration to expiration ratio (I:E). Specifically, 30 to 63 kg ruminants with an obstructed upper airway were resuscitated for 30 minutes from a hypoxic, hypercarbic, and acidotic state using 12- and 14-gauge catheters connected to a 50 psi oxygen source via a two-way valve with an I:E of 1:4 and 1:9 seconds, respectively. Shorter expiratory time or increased inspiratory time with these intravenous catheters resulted in significant hemodynamic compromise, barotrauma, inadequate carbon dioxide elimination, acidemia, and frequent death.

MeSH terms

  • Airway Obstruction / blood
  • Airway Obstruction / physiopathology
  • Airway Obstruction / therapy*
  • Airway Resistance
  • Animals
  • Barotrauma / etiology
  • Blood Gas Analysis
  • Catheters, Indwelling*
  • Disease Models, Animal
  • Goats
  • Hemodynamics
  • High-Frequency Ventilation / adverse effects
  • High-Frequency Ventilation / instrumentation*
  • High-Frequency Ventilation / methods
  • Lung Injury
  • Lung Volume Measurements
  • Sheep
  • Trachea*