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High-frequency jet ventilation for minimizing breathing-related liver motion during percutaneous radiofrequency ablation of multiple hepatic tumours


Biro, P; Spahn, D R; Pfammatter, T (2009). High-frequency jet ventilation for minimizing breathing-related liver motion during percutaneous radiofrequency ablation of multiple hepatic tumours. British Journal of Anaesthesia, 102(5):650-653.

Abstract

Movements of the liver caused by spontaneous breathing (during sedation or local anaesthesia) or by ventilation during anaesthesia are a source of concern in CT-guided procedures because of the limited spatial and contrast resolution of unenhanced imaging, artifacts caused by the probes and the relatively low temporal resolution of the fluoroscopy mode. During CT-guided radiofrequency ablation (RFA), it is essential that the lesion can be visualized optimally and that the ablation probe is positioned accurately to avoid non-target injuries. We therefore used high-frequency jet ventilation and general anaesthesia to minimize ventilation-related liver movement and provide optimal conditions for a patient undergoing RFA of hepatic metastases. The technical and anaesthetic considerations are discussed, and a specific limitation of transcutaneous Pco(2) measurement during activation of the ablation is reported for the first time.

Movements of the liver caused by spontaneous breathing (during sedation or local anaesthesia) or by ventilation during anaesthesia are a source of concern in CT-guided procedures because of the limited spatial and contrast resolution of unenhanced imaging, artifacts caused by the probes and the relatively low temporal resolution of the fluoroscopy mode. During CT-guided radiofrequency ablation (RFA), it is essential that the lesion can be visualized optimally and that the ablation probe is positioned accurately to avoid non-target injuries. We therefore used high-frequency jet ventilation and general anaesthesia to minimize ventilation-related liver movement and provide optimal conditions for a patient undergoing RFA of hepatic metastases. The technical and anaesthetic considerations are discussed, and a specific limitation of transcutaneous Pco(2) measurement during activation of the ablation is reported for the first time.

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8 citations in Web of Science®
11 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:24 Apr 2009 11:03
Last Modified:05 Apr 2016 13:12
Publisher:Oxford University Press
ISSN:0007-0912
Publisher DOI:10.1093/bja/aep051
PubMed ID:19346232
Permanent URL: http://doi.org/10.5167/uzh-18191

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