Abstract：
BACKGROUND: Highflow nasal cannula oxygen (HFNO) is known to be used for noninvasive oxygenation in intensive care patients but it has rarely been used in airway management for elective surgery of the upper aerodigestive tract.
OBJECTIVE: HFNO offers opportunities of a tubeless oxygenation system which is easy to handle and not limited only on surgery of the endolarynx.
METHODS: We evaluated this method for oxygenation during brief interventional procedures of the larynx and pharynx in 92 adult patients for safety and intraoperative complications. The need of secondary endotracheal intubation and limiting comorbidities as pulmonal and cardiac diseases were documented.
RESULTS: HFNO showed a good safety profile concerning saturation and hypercapnia. Oxygen desaturation below 90% occurred only in 5 patients, mask ventilation led to quick recovery except in one patient who was secondary intubated. A significant influence of the body mass index on the minimal O2 saturation was shown (p < 0,001) so that a possible limitation of the method exists here. Comorbidities were grouped into the ASA classification. There was a significant difference between ASA I/II and ASA III patients in terms of minimum O2saturation.
CONCLUSIONS: We conclude that HFNO may hold great promise for changing ventilator technique in general anesthesia, particularly in short elective laryngeal and pharyngeal surgery. Safety and feasibility were proven in this study.
OBJECTIVE: HFNO offers opportunities of a tubeless oxygenation system which is easy to handle and not limited only on surgery of the endolarynx.
METHODS: We evaluated this method for oxygenation during brief interventional procedures of the larynx and pharynx in 92 adult patients for safety and intraoperative complications. The need of secondary endotracheal intubation and limiting comorbidities as pulmonal and cardiac diseases were documented.
RESULTS: HFNO showed a good safety profile concerning saturation and hypercapnia. Oxygen desaturation below 90% occurred only in 5 patients, mask ventilation led to quick recovery except in one patient who was secondary intubated. A significant influence of the body mass index on the minimal O2 saturation was shown (p < 0,001) so that a possible limitation of the method exists here. Comorbidities were grouped into the ASA classification. There was a significant difference between ASA I/II and ASA III patients in terms of minimum O2saturation.
CONCLUSIONS: We conclude that HFNO may hold great promise for changing ventilator technique in general anesthesia, particularly in short elective laryngeal and pharyngeal surgery. Safety and feasibility were proven in this study.
摘要：
背景：Highflow鼻插管吸氧（HFNO）已知可用于重症监护患者的非侵入性氧合，但很少用于上呼吸道消化道择期手术的气道管理。
目的：HFNO提供了无管充氧系统的机会，该系统易于操作，不仅限于内咽手术。
方法：我们在92例成年患者的喉部和咽部短暂介入手术中评估了该方法的氧合安全性和术中并发症。记录了继发性气管内插管和限制肺部和心脏疾病的合并症的需要。
结果：HFNO在饱和和高碳酸血症方面表现出良好的安全性。氧饱和度低于90％仅发生在5例患者中，除一名二次插管的患者外，面罩通气导致快速恢复。显示了体重指数对最小O2饱和度的显着影响（p<0,001），因此此处存在该方法的可能限制。合并症分为ASA分类。就最低O2饱和度而言，ASAI/II和ASAIII患者之间存在显着差异。
结论：我们得出结论，HFNO可能对改变全身麻醉中的呼吸机技术有很大的希望，特别是在短期选择性喉部和咽部手术中。本研究证明了安全性和可行性。
目的：HFNO提供了无管充氧系统的机会，该系统易于操作，不仅限于内咽手术。
方法：我们在92例成年患者的喉部和咽部短暂介入手术中评估了该方法的氧合安全性和术中并发症。记录了继发性气管内插管和限制肺部和心脏疾病的合并症的需要。
结果：HFNO在饱和和高碳酸血症方面表现出良好的安全性。氧饱和度低于90％仅发生在5例患者中，除一名二次插管的患者外，面罩通气导致快速恢复。显示了体重指数对最小O2饱和度的显着影响（p<0,001），因此此处存在该方法的可能限制。合并症分为ASA分类。就最低O2饱和度而言，ASAI/II和ASAIII患者之间存在显着差异。
结论：我们得出结论，HFNO可能对改变全身麻醉中的呼吸机技术有很大的希望，特别是在短期选择性喉部和咽部手术中。本研究证明了安全性和可行性。
