Intrapulmonary percussive ventilation via Mini-Trach II in critical care: a case report

Emina Niisato; Yoshiyuki Hiramoto; Hitoshi Yamada; Naoki Matsumiya

doi:10.1186/s40981-021-00464-6

Intrapulmonary percussive ventilation via Mini-Trach II in critical care: a case report

JA Clin Rep. 2021 Aug 6;7(1):60. doi: 10.1186/s40981-021-00464-6.

Authors

Emina Niisato¹, Yoshiyuki Hiramoto², Hitoshi Yamada³, Naoki Matsumiya⁴

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1703, Japan. niisato.e@gmail.com.
² Department of Anesthesiology, Urayasu Hospital, Juntendo University, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
³ Department of Emergency and Intensive Care Medicine, Tsuchiura Kyodo General Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan.
⁴ Department of Anesthesiology, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, 300-0028, Japan.

Abstract

Background: Intrapulmonary percussive ventilation (IPV) facilitates the mobilization and clearance of bronchial secretions. Cricothyroidotomy using a Mini-Trach II device is a minimally invasive method used for secretion clearance. To our knowledge, there are no previous reports regarding IPV combined with Mini-Trach II.

Case presentation: An 82-year-old man underwent controlled mechanical ventilation and IPV via an endotracheal tube to treat atelectasis following emergency surgical repair of a traumatic diaphragm laceration. He underwent cricothyroidotomy using Mini-Trach II for ensuring airway management after extubation. On resumption, IPV through a mouthpiece or face mask was unsuccessful owing to air leakage from his mouth. However, IPV via the already inserted Mini-Trach II could deliver the percussion flow and led to a marked improvement in his condition.

Conclusion: This experience indicates that Mini-Trach II is beneficial as a minimally invasive interface for IPV that can deliver percussion flow efficiently.

Keywords: Atelectasis; Diaphragmatic dysfunction; Diaphragmatic injury; Intrapulmonary percussive ventilation; Mini-Trach II.