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Abstract：
BACKGROUND: Apnoeic oxygenation using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) during general anaesthesia prolongs the safe apnoeic period. However, there is a gap of knowledge how THRIVE-induced hyperoxia and hypercapnia impact vital organs. The primary aim of this randomised controlled trial was to characterise oxidative stress and, secondary, vital organ function biomarkers during THRIVE compared to mechanical ventilation (MV).
METHODS: Thirty adult patients, American Society of Anesthesiologists (ASA) 1-2, undergoing short laryngeal surgery under general anaesthesia were randomised to THRIVE, FI O2 1.0, 70 L min-1 during apnoea or MV. Blood biomarkers for oxidative stress, malondialdehyde and TAC and vital organ function were collected (A) preoperatively, (B) at procedure completion and (C) at PACU discharge.
RESULTS: Mean apnoea time was 17.9 (4.8) min and intubation to end-of-surgery time was 28.1 (12.8) min in the THRIVE and MV group, respectively. Malondialdehyde increased from 11.2 (3.1) to 12.7 (3.1) µM (P = .02) and from 9.5 (2.2) to 11.6 (2.6) µM (P = .003) (A to C) in the THRIVE and MV group, respectively. S100B increased from 0.05 (0.02) to 0.06 (0.02) µg L-1 (P = .005) (A to C) in the THRIVE group. No increase in TAC, CRP, leukocyte count, troponin-T, NTproBNP, creatinine, eGFRcrea or NSE was demonstrated during THRIVE.
CONCLUSIONS: While THRIVE and MV was associated with increased oxidative stress, we found no change in cardiac, inflammation or kidney biomarkers during THRIVE. Further evaluation of stress and inflammatory response and cerebral and cardiac function during THRIVE is needed.
METHODS: Thirty adult patients, American Society of Anesthesiologists (ASA) 1-2, undergoing short laryngeal surgery under general anaesthesia were randomised to THRIVE, FI O2 1.0, 70 L min-1 during apnoea or MV. Blood biomarkers for oxidative stress, malondialdehyde and TAC and vital organ function were collected (A) preoperatively, (B) at procedure completion and (C) at PACU discharge.
RESULTS: Mean apnoea time was 17.9 (4.8) min and intubation to end-of-surgery time was 28.1 (12.8) min in the THRIVE and MV group, respectively. Malondialdehyde increased from 11.2 (3.1) to 12.7 (3.1) µM (P = .02) and from 9.5 (2.2) to 11.6 (2.6) µM (P = .003) (A to C) in the THRIVE and MV group, respectively. S100B increased from 0.05 (0.02) to 0.06 (0.02) µg L-1 (P = .005) (A to C) in the THRIVE group. No increase in TAC, CRP, leukocyte count, troponin-T, NTproBNP, creatinine, eGFRcrea or NSE was demonstrated during THRIVE.
CONCLUSIONS: While THRIVE and MV was associated with increased oxidative stress, we found no change in cardiac, inflammation or kidney biomarkers during THRIVE. Further evaluation of stress and inflammatory response and cerebral and cardiac function during THRIVE is needed.
摘要：
背景：全身麻醉期间使用经鼻加湿快速吹气换气（THRIVE）的呼吸暂停氧合延长了安全的呼吸暂停期。然而,知识的空白引起的高氧和高碳酸血症如何影响重要器官。这项随机对照试验的主要目的是表征氧化应激，次要,与机械通气（MV）相比，THRIVE期间的重要器官功能生物标志物。
方法：30名成年患者，在全身麻醉下接受短喉手术的美国麻醉医师协会（ASA）1-2被随机分配到THRIVE，呼吸暂停或MV期间的FIO21.0，70Lmin-1。氧化应激的血液生物标志物，术前收集丙二醛和TAC和重要器官功能(A)，(B)在程序完成时和(C)在PACU放电时。
结果：在THRIVE和MV组中，平均呼吸暂停时间为17.9（4.8）分钟，插管至手术结束时间为28.1（12.8）分钟，分别。在THRIVE和MV组中，丙二醛从11.2（3.1）增加到12.7（3.1）µM（P=.02），从9.5（2.2）增加到11.6（2.6）µM（P=.003）（A到C），分别。在THRIVE组中，S100B从0.05（0.02）增加到0.06（0.02）µgL-1（P=0.005）（A到C）。TAC没有增加，CRP,白细胞计数,肌钙蛋白T,NTproBNP,肌酐,eGFR-crea或NSE在术中表现出来。
结论：虽然THRIVE和MV与氧化应激增加有关，我们没有发现心脏的变化,术中炎症或肾脏生物标志物。需要进一步评估THRIVE期间的应激和炎症反应以及脑和心脏功能。
方法：30名成年患者，在全身麻醉下接受短喉手术的美国麻醉医师协会（ASA）1-2被随机分配到THRIVE，呼吸暂停或MV期间的FIO21.0，70Lmin-1。氧化应激的血液生物标志物，术前收集丙二醛和TAC和重要器官功能(A)，(B)在程序完成时和(C)在PACU放电时。
结果：在THRIVE和MV组中，平均呼吸暂停时间为17.9（4.8）分钟，插管至手术结束时间为28.1（12.8）分钟，分别。在THRIVE和MV组中，丙二醛从11.2（3.1）增加到12.7（3.1）µM（P=.02），从9.5（2.2）增加到11.6（2.6）µM（P=.003）（A到C），分别。在THRIVE组中，S100B从0.05（0.02）增加到0.06（0.02）µgL-1（P=0.005）（A到C）。TAC没有增加，CRP,白细胞计数,肌钙蛋白T,NTproBNP,肌酐,eGFR-crea或NSE在术中表现出来。
结论：虽然THRIVE和MV与氧化应激增加有关，我们没有发现心脏的变化,术中炎症或肾脏生物标志物。需要进一步评估THRIVE期间的应激和炎症反应以及脑和心脏功能。
