Anesthesiological and Respiratory Specialties of Percutaneous Dilatational Tracheotomies

The ideal form of ventilation during PDT should allow oxygenation and ventilation of the intensive care patient on the one hand and ensure permanent endoscopic control of PDT on the other. Various ventilation methods and anesthesia options for PDT are described in detail in this chapter. The usual endoscopy procedures as well as the special feature of lumen reduction in endotracheal tubes through flexible endoscopes, Intermittent Positive Pressure Ventilation (IPPV) and Superimposed High-frequency Jet Ventilation (SHFJV®) are taken into account. The convenient possibilities of the SHFJV are described in detail with regard to their mode of operation, the required equipment technology, monitoring and procedural instructions. The basic physics and fluid mechanical phenomena of the SHFJV are presented in a practice-oriented way. Information on human and technical resources for PDT, also from the point of view of medical law, is given.