Document Detail


Feasibility of standard mechanical ventilation with low FiO2 and small endotracheal tubes during laser microlaryngeal surgery.
MedLine Citation:
PMID:  19536859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: No technique can be considered as a gold standard for ventilation during direct laser CO2 laryngeal microsurgery. We evaluated the feasibility of standard ventilation with laser-safe endotracheal tubes (ETTs) and inspired O2 fraction (FiO2) = 0.21 during direct microlaryngoscopy.
METHODS: During total intravenous anesthesia, standard mechanical normoventilation was set with FiO2 = 0.21 and 50 mm Hg peak inspiratory pressure limit. If SpO2 was <90% for >2 minutes, FiO2 was increased to 0.3; after 4 minutes it was increased to 0.4; after another 4 minutes, positive end-expiratory pressure (PEEP) could be set at 5 cm H2O; and after another 4 minutes, surgery was stopped if SpO2 remained <90%.
RESULTS: We studied 111 consecutive direct microlaryngoscopies on different patients. Four patients (3.6%) suffered minor intraoperative desaturation. Barotrauma was not observed, PEEP was never applied, and surgery was never stopped. Body mass index was independently predictive of the occurrence of intraoperative desaturation.
CONCLUSIONS: Standard mechanical ventilation with FiO2 = 0.21 through laser-safe ETTs is feasible during direct microlaryngoscopy.
Authors:
Elisa Nicelli; Marco Gemma; Assunta De Vitis; Giuseppe Foti; Luigi Beretta
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  32     ISSN:  1097-0347     ISO Abbreviation:  Head Neck     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-13     Completed Date:  2010-03-25     Revised Date:  2013-06-21    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-9     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley Periodicals, Inc.
Affiliation:
Department of Head and Neck Anesthesia and Intensive Care, Scientific Institute Hospital San Raffaele, Milano, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Feasibility Studies
Female
Humans
Intubation, Intratracheal / instrumentation*
Laryngoscopy / methods*
Larynx / surgery
Laser Therapy*
Male
Microsurgery
Middle Aged
Oxygen / administration & dosage*,  blood
Prospective Studies
Respiration, Artificial*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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