PDF(Pubmed)
Abstract：
BACKGROUND: Bleeding is a known complication during bronchoscopy, with increased incidence in patients undergoing a more invasive procedure. Phenylephrine is a potent vasoconstrictor that can control airway bleeding when applied topically and has been used as an alternative to epinephrine. The clinical effects of endobronchial phenylephrine on systemic vasoconstriction have not been clearly evaluated. Here, we compared the effects of endobronchial phenylephrine versus cold saline on systemic blood pressure.
METHODS: In all, 160 patients who underwent bronchoscopy and received either endobronchial phenylephrine or cold saline from July 1, 2017 to June 30, 2022 were included in this retrospective observational study. Intra-procedural blood pressure absolute and percent changes were measured and compared between the 2 groups.
RESULTS: There were no observed statistical differences in blood pressure changes between groups. The median absolute change between the median and the maximum intra-procedural systolic blood pressure in the cold saline group was 29 mm Hg (IQR 19 to 41) compared with 31.8 mm Hg (IQR 18 to 45.5) in the phenylephrine group. The corresponding median percent changes in SBP were 33.6 % (IQR 18.8 to 39.4) and 28% (IQR 16.8 to 43.5) for the cold saline and phenylephrine groups, respectively. Similarly, there were no statistically significant differences in diastolic and mean arterial blood pressure changes between both groups.
CONCLUSIONS: We found no significant differences in median intra-procedural systemic blood pressure changes comparing patients who received endobronchial cold saline to those receiving phenylephrine. Overall, this argues for the vascular and systemic safety of phenylephrine for airway bleeding as a reasonable alternative to epinephrine.
METHODS: In all, 160 patients who underwent bronchoscopy and received either endobronchial phenylephrine or cold saline from July 1, 2017 to June 30, 2022 were included in this retrospective observational study. Intra-procedural blood pressure absolute and percent changes were measured and compared between the 2 groups.
RESULTS: There were no observed statistical differences in blood pressure changes between groups. The median absolute change between the median and the maximum intra-procedural systolic blood pressure in the cold saline group was 29 mm Hg (IQR 19 to 41) compared with 31.8 mm Hg (IQR 18 to 45.5) in the phenylephrine group. The corresponding median percent changes in SBP were 33.6 % (IQR 18.8 to 39.4) and 28% (IQR 16.8 to 43.5) for the cold saline and phenylephrine groups, respectively. Similarly, there were no statistically significant differences in diastolic and mean arterial blood pressure changes between both groups.
CONCLUSIONS: We found no significant differences in median intra-procedural systemic blood pressure changes comparing patients who received endobronchial cold saline to those receiving phenylephrine. Overall, this argues for the vascular and systemic safety of phenylephrine for airway bleeding as a reasonable alternative to epinephrine.
摘要：
背景：出血是支气管镜检查期间的已知并发症，在接受更具侵入性手术的患者中发病率增加。去氧肾上腺素是一种有效的血管收缩剂，当局部应用时可以控制气道出血，并已被用作肾上腺素的替代品。支气管内苯肾上腺素对全身血管收缩的临床效果尚未明确评估。这里,我们比较了支气管内苯肾上腺素与冷盐水对全身血压的影响。
方法：总之，从2017年7月1日至2022年6月30日接受支气管镜检查并接受支气管内苯肾上腺素或冷盐水的160例患者被纳入这项回顾性观察研究。测量并比较两组之间的术中绝对血压和百分比变化。
结果：组间血压变化无统计学差异。冷盐水组的中位和最大术中收缩压之间的中位绝对变化为29mmHg（IQR19至41），而去氧肾上腺素组为31.8mmHg（IQR18至45.5）。冷盐水和去氧肾上腺素组相应的SBP变化中位数分别为33.6%(IQR18.8至39.4)和28%(IQR16.8至43.5),分别。同样，两组间舒张压和平均动脉压变化无统计学差异.
结论：我们发现接受支气管内冷盐水的患者与接受去氧肾上腺素的患者相比，术中全身血压的中位数变化没有显著差异。总的来说,这证明了去氧肾上腺素作为肾上腺素的合理替代方案治疗气道出血的血管和全身安全性.
方法：总之，从2017年7月1日至2022年6月30日接受支气管镜检查并接受支气管内苯肾上腺素或冷盐水的160例患者被纳入这项回顾性观察研究。测量并比较两组之间的术中绝对血压和百分比变化。
结果：组间血压变化无统计学差异。冷盐水组的中位和最大术中收缩压之间的中位绝对变化为29mmHg（IQR19至41），而去氧肾上腺素组为31.8mmHg（IQR18至45.5）。冷盐水和去氧肾上腺素组相应的SBP变化中位数分别为33.6%(IQR18.8至39.4)和28%(IQR16.8至43.5),分别。同样，两组间舒张压和平均动脉压变化无统计学差异.
结论：我们发现接受支气管内冷盐水的患者与接受去氧肾上腺素的患者相比，术中全身血压的中位数变化没有显著差异。总的来说,这证明了去氧肾上腺素作为肾上腺素的合理替代方案治疗气道出血的血管和全身安全性.
