Abstract：
Surgical correction of tracheobronchomalacia (TBM) has evolved greatly over the past decade, with select pediatric institutions establishing dedicated surgery and anesthesia teams to navigate the complexities and challenges of surgical airway repairs. Although anesthetic techniques have evolved internally over many years to improve patient safety and outcomes, many of these methods remain undescribed in literature.
In this article, we describe the intraoperative negative pressure suction test. This simulates the negative pressure seen in awake and spontaneously breathing patients, including the higher pressures seen during coughing which induce airway collapse in patients with TBM. Also known as the Munoz maneuver in surgical literature, this test has been performed on over 300 patients since 2015.
The negative pressure suction test allows for controlled intraoperative assessment of surgical airway repairs, replaces the need for risky intraoperative wake-up tests, increases the chances of a successful surgical repair, and improves anesthetic management for emergence and extubation. We provide a guide on how to perform the test and videos demonstrating its efficacy in intraoperative airway evaluation.
As surgeries to repair TBM become more prevalent in other pediatric institutions, we believe that pediatric patients and anesthesia providers will benefit from the insights and methods described here.
In this article, we describe the intraoperative negative pressure suction test. This simulates the negative pressure seen in awake and spontaneously breathing patients, including the higher pressures seen during coughing which induce airway collapse in patients with TBM. Also known as the Munoz maneuver in surgical literature, this test has been performed on over 300 patients since 2015.
The negative pressure suction test allows for controlled intraoperative assessment of surgical airway repairs, replaces the need for risky intraoperative wake-up tests, increases the chances of a successful surgical repair, and improves anesthetic management for emergence and extubation. We provide a guide on how to perform the test and videos demonstrating its efficacy in intraoperative airway evaluation.
As surgeries to repair TBM become more prevalent in other pediatric institutions, we believe that pediatric patients and anesthesia providers will benefit from the insights and methods described here.
摘要：
背景：在过去的十年中，气管支气管软化症（TBM）的手术矫正有了很大的发展，选择儿科机构建立专门的手术和麻醉团队，以应对手术气道修复的复杂性和挑战。尽管多年来麻醉技术已经在内部发展，以提高患者的安全性和预后，其中许多方法在文献中仍未描述。
方法：在本文中，我们描述了术中负压吸引试验。这模拟了清醒和自主呼吸患者的负压，包括在咳嗽期间观察到的较高压力，这会导致TBM患者的气道塌陷。在外科文献中也被称为Munoz动作，自2015年以来，该测试已对300多名患者进行。
结论：负压吸引试验允许对手术气道修复进行控制的术中评估，取代了对危险的术中唤醒测试的需要，增加了手术修复成功的机会，改善苏醒和拔管的麻醉管理。我们提供了有关如何进行测试的指南和视频，以证明其在术中气道评估中的功效。
结论：随着修复TBM的手术在其他儿科机构变得越来越普遍，我们相信儿科患者和麻醉提供者将受益于本文所述的见解和方法.
方法：在本文中，我们描述了术中负压吸引试验。这模拟了清醒和自主呼吸患者的负压，包括在咳嗽期间观察到的较高压力，这会导致TBM患者的气道塌陷。在外科文献中也被称为Munoz动作，自2015年以来，该测试已对300多名患者进行。
结论：负压吸引试验允许对手术气道修复进行控制的术中评估，取代了对危险的术中唤醒测试的需要，增加了手术修复成功的机会，改善苏醒和拔管的麻醉管理。我们提供了有关如何进行测试的指南和视频，以证明其在术中气道评估中的功效。
结论：随着修复TBM的手术在其他儿科机构变得越来越普遍，我们相信儿科患者和麻醉提供者将受益于本文所述的见解和方法.
