What are the risks associated with transtracheal jet ventilation?

Transtracheal jet ventilation involves delivering oxygen directly into the trachea at a high flow rate. The primary risk associated with this technique is barotrauma, which is the result of increased pressure in the airways and lungs. When high-pressure jets of gas enter the trachea rapidly, they can cause over-distension of the alveoli, leading to rupture or damage of the lung tissues.

Barotrauma can result in complications such as pneumothorax (air in the pleural cavity) or pneumomediastinum (air in the mediastinum), both of which can significantly compromise respiratory function. The risk of barotrauma is compounded by factors such as the presence of pre-existing lung pathology, increased peak airway pressures, or prolonged use of high-pressure jets.

While other risks such as nasal fractures or hypocarbia could be concerns in certain contexts, they are not primary issues directly associated with transtracheal jet ventilation. Subcutaneous emphysema can occur as a result of barotrauma, but it is more of a consequence than a direct risk of the technique itself. Thus, barotrauma is the most pertinent and well-established risk to consider in the context of transtracheal jet ventilation.