Laryngotracheal stenosis (LTS) is a life-threatening condition with a number of causes. This session will review the evolving body of literature that demonstrates a strong relationship between COVID-19 and LTS. Awareness of post-COVID LTS can direct the CRNA to review the health record or identify physical exam cues suggestive of LTS. Patients with LTS required a distinct anesthesia plan and close cooperation with surgical colleagues. This session will use the Monsoon III high-frequency jet ventilator (HFJV) (Acutronic, Inc.) as an example platform. The distinct advantages of HFJV (with the Monsoon III as an example) in the LTS patient population will be examined and described. Better understanding HFJV physics, baseline settings, troubleshooting, and vital considerations improve surgical conditions surgical outcomes and patient safety. With this review, the CRNA can create a comprehensive anesthesia plan customized for the patient with LTS.
Learning Objectives:
Distinguish symptomology suggesting laryngotracheal stenosis (LTS) in patients with a history of intubation/ventilation for COVID-19.
Translate surgical and patient indications for high-frequency jet ventilation (HFJV).
Formulate an anesthetic plan for tracheal sleeve resection including high-frequency jet ventilation (HFJV), pharmacological techniques, and monitoring modalities.
