• Carrie F P Wong, Vivian M Yuen, Gordon T C Wong, Jensen To, and Michael G Irwin.
• Department of Anaesthesiology, Queen Mary Hospital, Hong Kong, China.
• Paediatr Anaesth. 2014 Feb 1;24(2):208-13.

IntroductionLimited information is available on the management of the 'cannot intubate, cannot ventilate' (CICV) situation in infants. We compared the time to achieve adequate oxygenation following rescue ventilation using the Enk oxygen flow modulator (OFM) with a jet ventilator in a simulated CICV situation using the rabbit as an infant respiratory model.MethodsFollowing institutional ethics committee approval, needle cricothyrotomy was performed under direct vision in nine anesthetized rabbits following surgical exposure of the larynx. After ensuring adequate level of anesthesia and analgesia, and confirming proper positioning of the 18G cannula, apnea was induced by the administration of myorelaxant and the SpO2 was allowed to drop to 75% before initiating rescue ventilation via either the OFM or jet ventilator.ResultsFive rabbits were ventilated with the OFM and four with the jet ventilator. Ventilation was maintained with either device for 15 min. All rabbits were successfully rescued using either device. There was no statistical difference in the time required for SpO2 to return to 80%, 85%, 90%, and 95%.ConclusionsBoth devices facilitated successful rescue ventilation through a needle cricothyrotomy.© 2013 John Wiley & Sons Ltd.

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