Manual versus Automated Jet ventilation and incidence of post procedural hypercarbia in Patients undergoing bronchoscopic procedures under anaesthesia for excision of tracheobronchial lesions in a tertiary care hospital - a prospective cohort study

Bronchoscopy-both Rigid and Flexible paves way for Diagnostic and therapeutic procedures to be performed in the tracheobronchial tree. These specific procedures form a common work field for both the Anaesthesiologist and the Interventional Pulmonologist involved, it also requires special management of the Airway which is most often already compromised or Vulnerable. Maintaining Spontaneous Ventilation through a compromised or narrow Airway is usually not a practical option and the depth of anaesthesia required to suppress protective airway reflexes also leads to considerable amount of respiratory depression and the introduction of a bronchoscope and other instruments further narrows the available airway thereby adding to the respiratory depression and CO2 retention.

Various methods have been used to maintain Oxygenation during Bronchoscopic procedure depending on the clinical scenario and the duration of Surgery. One such method is Jet ventilation- with its advantage being -the airway is left open for the maneuvering of various tools while simultaneously maintaining adequate gas exchange.

The most common complications associated with Jet ventilation are Hypercapnia, hypoxia and Haemodynamic Instability(1)

The Aim of our study is the compare the incidence of Hypercarbia in patients undergoing diagnostic or therapeutic bronchoscopy in manual and Automated jet ventilator by measuring the post procedure arterial PaCO2 levels, and to compare other parameters such as oxygen Saturation and arterial PaO2 to assess of effectiveness of ventilation in Manual and Jet Ventilation. The Study also aims to document and compare the incidence of Haemodynamic instability in both modes of Ventilation. By the end of our analysis we will be able to arrive at a consensus as to which mode of Jet ventilation is most effective in Preventing Hypercarbia, Hypoxemia and hemodynamic instability and thereby proving to be safer and superior to the other.