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
Related Documents :
7037709 - Effect of positive end-expiratory pressure and body position in unilateral lung injury.
1546829 - Left ventricular diastolic function during positive end-expiratory pressure. impact of ...
16199419 - Use of the proseal laryngeal mask airway for pressure-controlled ventilation with and w...
7011509 - Role of the pericardium and intact chest wall in the hemodynamic response to positive e...
17686119 - Viscoelastic properties of lungs and thoracic wall of anesthetized mechanically ventila...
18806039 - Pulmonary cytokine responses during mechanical ventilation of noninjured lungs with and...
15906079 - Whole-body heating slows carotid baroreflex response in human subjects.
718809 - Relation between total uterine impulse, method of delivery and one-minute apgar score.
7648669 - Acute hypertension induces heat-shock protein 70 gene expression in rat aorta.
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:  -    
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.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
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


Previous Document:  Late esophageal toxicity after radiation therapy for head and neck cancer.
Next Document:  Fibrosarcomatous transformation in dermatofibrosarcoma protuberans of the breast--a case report.