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Alexander Aloy
Medical University of Vienna, AustriaTitle: Endolaryngeal/Tracheal Surgery in Tubeless Superimposed High Frequency Jet Ventilation (SHFJV)
Abstract
Background:
Superimposed High-Frequency Jet Ventilation (SHFJV), which does not require any
tracheal tubes or catheters, was developed specifically for use in
laryngotracheal surgery. SHFJV uses two jet streams with different frequencies
simultaneously and is applied in the supraglottic space using a jet
laryngoscope and jet ventilator.
Methods:
Between 1990 and 2004, SHFJV was studied in 1515 consecutive patients
(including 158 children requiring laryngotracheal surgery) prospectively.
Ventilation was performed with an air/oxygen mixture and anaesthesia was
administered.
Results:
Adequate oxygenation and ventilation was achieved in 1512 patients. Arterial Blood
Gas Analyses (BGA) were performed between 1990 and 1994; Thereafter BGA was
only performed in patients with high-grade stenosis of the larynx/trachea or
high-risk patients [n=623, mean Pa(O(2)) 133.8 (39.4) mm Hg and mean Pa(CO(2))
42.3 (10.1) mm Hg]. There were no significant changes in Pa(O(2)) or Pa(CO(2))
during the entire period of SHFJV. No complications secondary to the
ventilation technique were observed; In particular, no barotrauma occurred.
Three patients required tracheal intubation. SHFJV was also successfully used
for laser surgery (n=312). It proved to be a safe mode of ventilation without
any complications such as airway fire, major haemorrhage, or aspiration of
debris.
Conclusion:
SHFJV is an advanced ventilation mode playing a pivotal role in the (open)
ventilatory support/ventilation of patients with laryngotracheal stenosis. It
is particularly indicated in cases of severe stenosis and offers optimal
conditions for laryngotracheal surgery, including laser surgery and stent
implantation techniques.
Biography
Alexander
Aloy was born 1950 and has completed his PHD at the age of 27 years from Vienna
University, Austria. He has published in renowned journals and edited two
specialist books. Through his scientific work, Superponated High-Frequency Jet
Ventilation became the state of the art in Europe. This form of jet ventilation
has become indispensable for interventions on small airways, laser surgery and
sup glottic stenoses as well as vocal cord surgery. He got the doctorate in the
year of 1977, and he completed anesthesiology in 1983. He is senior physician,
head of department, head of intensive care unit 13C1 and surgical group III
(ENT) at Vienna General Hospital (1994-2007). He got two scientific prizes. In
1994, he got Dr. Eugen Grabscheid Prize and in 2006, he got Theodor Billroth
Prize (Dr. Rezaie, Dr. Aloy et al.). He is editorship in jet ventilation:
Technical Basics and Clinical Applications, Springer Verlag 1994 and Surgical
Intensive Care Medicine, Springer Verlag in 2007. His other works include
patent development for Superponated High-Frequency Ventilation. Co-development
of a ventilator and retired from the University Clinic for Anaesthesia and
General Intensive Care Medicine. He is Vienna University of Technology ongoing
lecture SS2017: Fundamentals of respiratory physiology and ventilation
technology.
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