Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery

Abstract Background Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient’s same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal...

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Main Authors: Nguyen Minh Ly, Ngo Van Dinh, Dinh Thi Thu Trang, Ngo Vi Hai, Tong Xuan Hung
Format: Article
Language:English
Published: BMC 2022-03-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-022-01610-y
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author Nguyen Minh Ly
Ngo Van Dinh
Dinh Thi Thu Trang
Ngo Vi Hai
Tong Xuan Hung
author_facet Nguyen Minh Ly
Ngo Van Dinh
Dinh Thi Thu Trang
Ngo Vi Hai
Tong Xuan Hung
author_sort Nguyen Minh Ly
collection DOAJ
description Abstract Background Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient’s same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apneic conditions with high-flow oxygen as the sole method of gas exchange during anastomosis construction. Methods A prospective study was performed on 16 patients with tracheal stenosis, with ages ranging from 19 to 70, who underwent tracheal resection and reconstruction from April 2019 to August 2020 in 108 Military Central Hospital. During the anastomosis phase using high flow oxygen of 35–40 l.min-1 delivered across the open tracheal with an endotracheal tube (ETT) at the glottis in apnoeic conditions. Results The mean (SD) apnoea time was 20.91 (2.53) mins. Mean (SD) time anastomosis was 22.9 (2.41) mins. The saturation of oxygen was stable during all procedures at 98–100%. Arterial blood gas analysis showed mean (SD) was hypercapnia and acidosis acute respiratory after 10 mins of apnoea and 20 mins apnoea respectively. However, after 15 mins of ventilation, the parameters are ultimately returned to normal. All 16 patients were extubated early and safely at the end of the operation. There were no complications, such as bleeding, hemothorax, pneumothorax, or barotrauma. Conclusion High-flow oxygen across the open tracheal under apnoeic conditions can provide a satisfactory gas exchange to allow tubeless anesthesia for tracheal resection and reconstruction.
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spelling doaj.art-4cce761cdcb04d8fb3b98538b6f0a49e2022-12-21T22:51:28ZengBMCBMC Anesthesiology1471-22532022-03-012211910.1186/s12871-022-01610-yApnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgeryNguyen Minh Ly0Ngo Van Dinh1Dinh Thi Thu Trang2Ngo Vi Hai3Tong Xuan Hung4Department of Anesthesiology and Pain Medicine, 108 Military Central HospitalDepartment of Anesthesiology and Pain Medicine, 108 Military Central HospitalDepartment of Anesthesiology and Pain Medicine, 108 Military Central HospitalDepartment of Thoracic surgery, 108 Military Central HospitalDepartment of Anesthesiology and Pain Medicine, 108 Military Central HospitalAbstract Background Tracheal resection and reconstruction are the most effective treatments for tracheal stenosis, but the difficulties are surgery and maintaining ventilation performed on the patient’s same airway. High-flow oxygen has begun to be applied to prolong the apnoea time in the tracheal anastomosis period for tracheal resection and reconstruction. This study aims to evaluate the effectiveness of apneic conditions with high-flow oxygen as the sole method of gas exchange during anastomosis construction. Methods A prospective study was performed on 16 patients with tracheal stenosis, with ages ranging from 19 to 70, who underwent tracheal resection and reconstruction from April 2019 to August 2020 in 108 Military Central Hospital. During the anastomosis phase using high flow oxygen of 35–40 l.min-1 delivered across the open tracheal with an endotracheal tube (ETT) at the glottis in apnoeic conditions. Results The mean (SD) apnoea time was 20.91 (2.53) mins. Mean (SD) time anastomosis was 22.9 (2.41) mins. The saturation of oxygen was stable during all procedures at 98–100%. Arterial blood gas analysis showed mean (SD) was hypercapnia and acidosis acute respiratory after 10 mins of apnoea and 20 mins apnoea respectively. However, after 15 mins of ventilation, the parameters are ultimately returned to normal. All 16 patients were extubated early and safely at the end of the operation. There were no complications, such as bleeding, hemothorax, pneumothorax, or barotrauma. Conclusion High-flow oxygen across the open tracheal under apnoeic conditions can provide a satisfactory gas exchange to allow tubeless anesthesia for tracheal resection and reconstruction.https://doi.org/10.1186/s12871-022-01610-yTracheal resectionReconstructionStenosisAnesthesiaHigh-flowApnoeic oxygenation
spellingShingle Nguyen Minh Ly
Ngo Van Dinh
Dinh Thi Thu Trang
Ngo Vi Hai
Tong Xuan Hung
Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
BMC Anesthesiology
Tracheal resection
Reconstruction
Stenosis
Anesthesia
High-flow
Apnoeic oxygenation
title Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
title_full Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
title_fullStr Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
title_full_unstemmed Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
title_short Apnoeic oxygenation with high-flow oxygen for tracheal resection and reconstruction surgery
title_sort apnoeic oxygenation with high flow oxygen for tracheal resection and reconstruction surgery
topic Tracheal resection
Reconstruction
Stenosis
Anesthesia
High-flow
Apnoeic oxygenation
url https://doi.org/10.1186/s12871-022-01610-y
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