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High frequency jet ventilation during endolaryngeal surgery: Risk factors for complications
- Source :
- Auris Nasus Larynx. 45:1047-1052
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objective Microlaryngeal surgery requires teamwork between surgeons and anesthesiologists. High-frequency jet ventilation (HFJV) is an artificial breathing technique, preferred during endolaryngeal interventions, which offers a good solution for the requirements. Most studies investigating independent risk factors for intraoperative complications during HFJV in endolaryngeal surgery (ELS) has been retrospective and not standardized and the anesthetic approach has not been standardized. This prospective cohort study aimed to identify risk factors of complications related to HFJV in ELS under a standardized anesthesia regimen. Methods 243 patients who underwent ELS with infraglottic HFJV were investigated. Infraglottic jet ventilation catheter was placed and anesthesia was standardized. Demographic and operative data were noted. Hemodynamics, SpO2 and end-tidal CO2 were recorded at regular intervals. Complications such as hemodynamic disturbances, respiratory problems, barotrauma, equipment failure and requirement for conventional ventilation were also documented. Results 222 patients were included. Hypoxia, hypercapnia and the need for intubation were observed in 20(9%), 4(1.8%), 10(4.5%) patients. Bradycardia, hypotension and arrhythmia were observed in six (2.7%), 24(10.8%), and four (1.8%) patients respectively. Respiratory complications were associated with body mass index (BMI) (p < 0.001, OR: 1.57, 95%CI: 1.31–1.88) and previous major airway surgery (p < 0.001, OR: 34.0, 95%CI:3.52–328.24), whereas hemodynamic complications were associated with duration of the operation (p = 0.034, OR:1.04, 95%CI:1.0–1.09) and history of previous major airway surgery (p = 0.005, OR:9.57, 95%CI:1.97–46.49). Conclusion Infraglottic HFJV can be evaluated as an alternative breathing technique to conventional ventilation during endolaryngeal interventions. However, longer operation and previous laryngeal surgeries can increase the incidence of respiratory complications.
- Subjects :
- Male
Biopsy
medicine.medical_treatment
Respiratory Tract Diseases
Hemodynamics
Hypercapnia
0302 clinical medicine
Risk Factors
Intubation
Hypoxia
030223 otorhinolaryngology
Prospective cohort study
Age Factors
Respiratory Aspiration
Pneumothorax
General Medicine
Middle Aged
Subcutaneous Emphysema
Catheter
Barotrauma
030220 oncology & carcinogenesis
Female
Laser Therapy
medicine.symptom
Tracheal Stenosis
Vocal Cord Paralysis
medicine.drug
Adult
Bradycardia
medicine.medical_specialty
High-Frequency Jet Ventilation
Laryngeal Diseases
03 medical and health sciences
Intubation, Intratracheal
medicine
Humans
Laryngeal Neoplasms
Laryngoscopy
business.industry
Laryngostenosis
Dilatation
Respiration, Artificial
Surgery
Regimen
Logistic Models
Otorhinolaryngology
Anesthetic
business
Subjects
Details
- ISSN :
- 03858146
- Volume :
- 45
- Database :
- OpenAIRE
- Journal :
- Auris Nasus Larynx
- Accession number :
- edsair.doi.dedup.....44d6ba86970d7e7919769fec7000ad25