Feasibility study of transesophago-tracheal ventilation in a Beagle dog

Objectives Tracheal intubation is a commonly used technique which primarily employed for rescuing patients with respiratory failure or providing respiratory support during surgery. However, for patients with severe upper tracheal stenosis who cannot undergo intubation or tracheotomy, alternative methods are necessary to ensure adequate oxygen support. The extracorporeal membrane oxygenation (ECMO) system can supply oxygen without requiring tracheal intubation; however, this technology is expensive and not routinely available in most hospitals. This study aimed to preliminarily test the feasibility of transesophago-tracheal ventilation in a Beagle dog to solve this medical dilemma. Methods The operation was performed with the guidance of X-ray fluoroscopy. A Beagle dog was anesthetized followed by conventional tracheal intubation. The bronchoscope entered the esophagus through the mouth, and a needle punctured from the esophagus into the trachea through the endoscopic working channel, exiting with its distal end in the trachea. Subsequently, a cannula with an inner core was introduced into the trachea along with the puncture needle. Finally, the ventilation for Beagle dog was conducted via transesophago-tracheal tube. Results The experimental dog successfully completed the transesophago-tracheal intubation and ventilation under sedation and anesthesia. After successful intubation, the tracheal intubation channel was blocked, and the dog was ventilated solely through the transesophago-tracheal tube for 20 minutes. There was no significant decrease in SaO ₂ levels in the experimental dog. The dog resumed its diet on the second day after surgery, and no coughing occurred after drinking water. On the 7th day of post-operation, chest CT examination revealed neither mediastinal emphysema nor pneumothorax in the dog. Conclusions The preliminary results of this study confirm the feasibility of transesophago- tracheal ventilation. However, there are still several gaps for clinical application, and further studies will be needed in future experiments.