预期的困难气道的管理与计划的单肺通风:对44例病例的回顾性分析
Andrea Irouschek1, Joachim Schmidt1, Andreas Ackermann1
1Department of Anesthesiology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Bayern, Germany.
The Thoracic and cardiovascular surgeon
|November 12, 2024
概括
在胸部外科手术中,在单肺通风过程中管理困难的呼吸道是具有挑战性的. 这项研究发现,使用支气管阻塞剂进行清醒输管是安全有效的,符合新的指导方针.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 航空航道管理的管理.
背景情况:
- 难以控制呼吸道在麻醉中至关重要,特别是在单肺通风 (OLV) 期间.
- 在OLV期间预期的困难航线的具体指导方针很少.
- 最近的德国指南提供了建议,但支持数据有限.
研究的目的:
- 分析预期呼吸道困难的患者的呼吸道管理策略,这些患者接受了OLV的胸部手术.
- 根据新兴的指导方针,评估当前实践的安全性和有效性.
主要方法:
- 在2016年至2021年期间,对接受OLV胸部手术的成年患者进行了回顾性分析.
- 确定预期有呼吸道困难的患者.
- 对气道管理技术和结果的分析.
主要成果:
- 在3,197项手术中,44例涉及预期的呼吸道困难,通常是由于先前的头部/部癌症治疗.
- 标准方法是鼻腔支气管醒着输管,然后用视频喉科和支气管阻塞剂口腔再输管.
- 没有严重的并发症发生,在所有情况下都取得了成功的OLV.
结论:
- 量身定制的气道管理对于在OLV期间预期难以通风的患者至关重要.
- 与支气管阻塞剂一起使用单管似乎是有效的,并且可能比双管更安全.
- 该研究支持所述方法的安全性和实用性,因此需要进一步的多中心验证.
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