To Investigate Airway Oxygen Concentrations During Rigid Bronchoscopy Procedures Performed With High Frequency Jet Ventilation

Study Overview
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Brief Summary
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Thermal ablation (use of treatment modalities that generate heat) has become a widely used tool for treatment of central airway obstruction (e.g. laser, electrocautery, radiofrequency, and argon plasma coagulation). However, this method carries with it an increased risk for airway fire - a surgical fire that occurs in a patient's airway and could also include a fire in the attached breathing circuit. To decrease the risk of airway fire during mechanical ventilation with an endotracheal tube, the concentration of inspired oxygen (FiO2) is set below 40% while waiting for end tidal oxygen concentration (EtO2) to fall below 40% prior to starting thermal ablation. There is no published literature describing O2 concentration within the airways (AiO2) during jet ventilation with rigid bronchoscopy. The co-investigators of this study have recently collected data on AiO2 during rigid bronchoscopy using manual low frequency jet ventilation/high frequency jet ventilation with a period of apnea. The intent of this study is to measure the time taken for the central airway oxygen concentration to drop from 90 to 40% when the laser mode is activated on the Monsoon jet ventilator. Ventilation is continued during laser mode.

Official Title
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To Investigate Airway Oxygen Concentrations During Rigid Bronchoscopy Procedures Performed With High Frequency Jet Ventilation

Conditions
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Central Airway Obstruction

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing rigid bronchoscopy for treatment of central airway obstruction at FV UMMC will be identified. 18 years or older Need rigid bronchoscopy as pre-determined by the interventional pulmonologist Exclusion Criteria: Refusal to sign consent Pregnant patients Hemodynamic instability defined as continuous infusion of medication in order to support blood pressure and/or heart rate/rhythm Respiratory instability defined as SpO2&lt;90% with &gt;90% supplemental oxygen. Ineligible for rigid bronchoscopic intubation Latex allergy Evidence of fistulous airway Active Bronchopleural fistula

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|This is an observational study|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time in seconds to AiO2 from 90 to 40% | Time in seconds to AiO2 from 90 to 40% after activating laser mode on the monsoon jet ventilator. | baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Differences in time to laser mode AiO2 | Differences in time to laser mode AiO2 between trachea and left and right mainstem bronchi. | baseline |