PDF(Pubmed)
Abstract：
UNASSIGNED: Since 2015, Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) has been used in general anesthesia for preoxygenation or difficult exposure airway management. Its use offers new opportunities in laryngology. THRIVE increases apnea time and frees the access to the upper airway. However, its use may be less stable than orotracheal intubation. The main objective of this work was to evaluate the feasibility of laryngeal microsurgery under THRIVE including using Laser.
UNASSIGNED: Retrospective.
UNASSIGNED: A total of N = 99 patients with laryngeal microsurgery (with or without CO2 laser) under THRIVE were included successively from January 1, 2020 to January 30, 2022.
UNASSIGNED: Medical history, comorbidities, clinical and surgical data were extracted and analyzed. Two groups were constituted regarding the \"success\" (use of THRIVE along all the procedure) or the \"failure\" (need for an endotracheal tube) of the use of THRIVE during the procedure.
UNASSIGNED: A failure occurred in N = 15/99 patients (15.2%) mainly due to refractory hypoxia. The odd ratios (OR) for THRIVE failure were: OR = 6.6 [2.9-35] for overweight (BMI >25 kg/m2); OR = 3.8 [1.7-18.7] for ASA score >2; OR = 4.7 [2.3-24.7] for the use of CO2 laser. Elderly patients and patients with pulmonary pathology were not statistically at greater risk of THRIVE failure. No adverse event was described.
UNASSIGNED: This work confirms the feasibility of laryngeal microsurgery under THRIVE, including with CO2 laser. Overweight, ASA >2 and lower fraction of inspired oxygen during CO2 laser use increased the risk for orotracheal intubation.
UNASSIGNED: Retrospective.
UNASSIGNED: A total of N = 99 patients with laryngeal microsurgery (with or without CO2 laser) under THRIVE were included successively from January 1, 2020 to January 30, 2022.
UNASSIGNED: Medical history, comorbidities, clinical and surgical data were extracted and analyzed. Two groups were constituted regarding the \"success\" (use of THRIVE along all the procedure) or the \"failure\" (need for an endotracheal tube) of the use of THRIVE during the procedure.
UNASSIGNED: A failure occurred in N = 15/99 patients (15.2%) mainly due to refractory hypoxia. The odd ratios (OR) for THRIVE failure were: OR = 6.6 [2.9-35] for overweight (BMI >25 kg/m2); OR = 3.8 [1.7-18.7] for ASA score >2; OR = 4.7 [2.3-24.7] for the use of CO2 laser. Elderly patients and patients with pulmonary pathology were not statistically at greater risk of THRIVE failure. No adverse event was described.
UNASSIGNED: This work confirms the feasibility of laryngeal microsurgery under THRIVE, including with CO2 laser. Overweight, ASA >2 and lower fraction of inspired oxygen during CO2 laser use increased the risk for orotracheal intubation.
摘要：
■自2015年以来，经鼻加湿快速通气换气（THRIVE）已用于全身麻醉，用于预氧合或困难的暴露气道管理。它的使用为喉科提供了新的机会。THRIVE增加了呼吸暂停时间并释放了进入上呼吸道的通道。然而,其使用可能不如经口气管插管稳定。这项工作的主要目的是评估THRIVE下喉显微手术的可行性，包括使用激光。
■回顾性研究。
■从2020年1月1日至2022年1月30日，连续纳入了在THRIVE下进行喉显微手术（有或没有CO2激光）的N=99例患者。
■病史，合并症,临床和手术资料进行提取和分析。根据手术期间使用THRIVE的“成功”（在所有手术中使用THRIVE）或“失败”（需要气管内插管）组成两组。
■N=15/99患者（15.2％）发生失败，主要是由于难治性缺氧。THRIVE失败的奇数比率（OR）为：超重（BMI>25kg/m2）的OR=6.6[2.9-35]；ASA评分>2的OR=3.8[1.7-18.7]；使用CO2激光的OR=4.7[2.3-24.7]。老年患者和肺部病理患者在统计上没有更大的THRIVE失败风险。没有描述不良事件。
■这项工作证实了THRIVE下喉显微手术的可行性，包括CO2激光。超重,ASA>2和CO2激光使用期间吸入的氧气含量较低增加了经气管插管的风险。
■回顾性研究。
■从2020年1月1日至2022年1月30日，连续纳入了在THRIVE下进行喉显微手术（有或没有CO2激光）的N=99例患者。
■病史，合并症,临床和手术资料进行提取和分析。根据手术期间使用THRIVE的“成功”（在所有手术中使用THRIVE）或“失败”（需要气管内插管）组成两组。
■N=15/99患者（15.2％）发生失败，主要是由于难治性缺氧。THRIVE失败的奇数比率（OR）为：超重（BMI>25kg/m2）的OR=6.6[2.9-35]；ASA评分>2的OR=3.8[1.7-18.7]；使用CO2激光的OR=4.7[2.3-24.7]。老年患者和肺部病理患者在统计上没有更大的THRIVE失败风险。没有描述不良事件。
■这项工作证实了THRIVE下喉显微手术的可行性，包括CO2激光。超重,ASA>2和CO2激光使用期间吸入的氧气含量较低增加了经气管插管的风险。
