PDF(Pubmed)
Abstract：
UNASSIGNED: Prolonged intubation is a known risk factor of LTS. LTS related to COVID-19 may result in a different phenotype: pronation affects the location of stenosis and COVID-19 pneumonia can decline lung mechanics. Therefore, airway management in these patients may carry unique challenges for both anesthesiologists and surgeons.This prospective observational feasibility trial aims to evaluate the use of a novel thin, cuffed, endotracheal tube (Tritube) in combination with flow-controlled ventilation (FCV) in the management of patients with COVID-19-related LTS undergoing laryngeal surgery.
UNASSIGNED: 20 patients suffering from COVID-19-related LTS, as diagnosed by CT, requiring endolaryngeal surgery, with or without CO2 laser, were included. Ultrathin endotracheal tube Tritube, together with FCV was used for airway management and ventilation. Feasibility, ventilation efficiency, and surgical exposure were evaluated.
UNASSIGNED: Median duration of mechanical ventilation during their ICU stay was 17 days, (range, 7-27), and all patients had been pronated. In 18/20 patients, endoscopic diagnosis confirmed the initial CT diagnosis: posterior subglottic stenosis. Surgeons\' satisfaction on the view was rated 9 out of 10 (range 7-10), where 0 was the worst view and 10 was the best view. Hemodynamic and respiratory variables were within the normal clinical range during the surgical procedure. One patient that had a SpO2 of 90% before induction of anesthesia, a temporal drop to 89%, caused meeting the predefined requirement of \"respiratory complication.\"
UNASSIGNED: This study demonstrates the feasibility of using Tritube with FCV in patients with relatively unusual subglottic posterior location tracheal stenosis, undergoing laryngotracheal surgery. Tritube provides a good surgical field and FCV provides highly adequate ventilation especially in patients with compromised lung mechanics.
UNASSIGNED: IV, non-comparitive prospective clinical trial with 20 patients.
UNASSIGNED: 20 patients suffering from COVID-19-related LTS, as diagnosed by CT, requiring endolaryngeal surgery, with or without CO2 laser, were included. Ultrathin endotracheal tube Tritube, together with FCV was used for airway management and ventilation. Feasibility, ventilation efficiency, and surgical exposure were evaluated.
UNASSIGNED: Median duration of mechanical ventilation during their ICU stay was 17 days, (range, 7-27), and all patients had been pronated. In 18/20 patients, endoscopic diagnosis confirmed the initial CT diagnosis: posterior subglottic stenosis. Surgeons\' satisfaction on the view was rated 9 out of 10 (range 7-10), where 0 was the worst view and 10 was the best view. Hemodynamic and respiratory variables were within the normal clinical range during the surgical procedure. One patient that had a SpO2 of 90% before induction of anesthesia, a temporal drop to 89%, caused meeting the predefined requirement of \"respiratory complication.\"
UNASSIGNED: This study demonstrates the feasibility of using Tritube with FCV in patients with relatively unusual subglottic posterior location tracheal stenosis, undergoing laryngotracheal surgery. Tritube provides a good surgical field and FCV provides highly adequate ventilation especially in patients with compromised lung mechanics.
UNASSIGNED: IV, non-comparitive prospective clinical trial with 20 patients.
摘要：
■长时间插管是LTS的已知危险因素。与COVID-19相关的LTS可能导致不同的表型：内旋影响狭窄的位置，COVID-19肺炎可降低肺力学。因此,这些患者的气道管理可能对麻醉医师和外科医生带来独特的挑战.这项前瞻性观察可行性试验旨在评估一种新型薄薄的使用，袖口,气管导管（Tritube）与流量控制通气（FCV）联合用于治疗COVID-19相关的LTS喉部手术患者。
■20名患有COVID-19相关LTS的患者，通过CT诊断，需要进行喉内手术,有或没有CO2激光，包括在内。超薄气管导管Tritube,与FCV一起用于气道管理和通气.可行性,通风效率，和手术暴露进行了评估。
■ICU住院期间机械通气的中位持续时间为17天，(范围,7-27),所有的病人都被旋前。在18/20患者中，内镜诊断证实最初CT诊断：后声门下狭窄。外科医生对视图的满意度被评为10分中的9分（范围7-10），其中0是最差的视图，10是最好的视图。手术期间血液动力学和呼吸变量在正常临床范围内。一名患者在麻醉诱导前有90%的SpO2,暂时下降到89%，导致满足“呼吸系统并发症”的预定义要求。\"
■这项研究证明了在相对异常的声门下后位置气管狭窄患者中使用Tritube和FCV的可行性，正在接受喉气管手术.Tritube提供了良好的手术领域，FCV提供了充分的通气，尤其是在肺力学受损的患者中。
■IV，20例患者的非可比性前瞻性临床试验。
■20名患有COVID-19相关LTS的患者，通过CT诊断，需要进行喉内手术,有或没有CO2激光，包括在内。超薄气管导管Tritube,与FCV一起用于气道管理和通气.可行性,通风效率，和手术暴露进行了评估。
■ICU住院期间机械通气的中位持续时间为17天，(范围,7-27),所有的病人都被旋前。在18/20患者中，内镜诊断证实最初CT诊断：后声门下狭窄。外科医生对视图的满意度被评为10分中的9分（范围7-10），其中0是最差的视图，10是最好的视图。手术期间血液动力学和呼吸变量在正常临床范围内。一名患者在麻醉诱导前有90%的SpO2,暂时下降到89%，导致满足“呼吸系统并发症”的预定义要求。\"
■这项研究证明了在相对异常的声门下后位置气管狭窄患者中使用Tritube和FCV的可行性，正在接受喉气管手术.Tritube提供了良好的手术领域，FCV提供了充分的通气，尤其是在肺力学受损的患者中。
■IV，20例患者的非可比性前瞻性临床试验。
