Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review.

Détails

ID Serval
serval:BIB_E89D629E674E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review.
Périodique
Anesthesiology
Auteur(s)
Jaquet Y., Monnier P., Van Melle G., Ravussin P., Spahn D.R., Chollet-Rivier M.
ISSN
0003-3022
Statut éditorial
Publié
Date de publication
2006
Peer-reviewed
Oui
Volume
104
Numéro
1
Pages
52-9
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Résumé
BACKGROUND: Spontaneous ventilation, mechanical controlled ventilation, apneic intermittent ventilation, and jet ventilation are commonly used during interventional suspension microlaryngoscopy. The aim of this study was to investigate specific complications of each technique, with special emphasis on transtracheal and transglottal jet ventilation. METHODS: The authors performed a retrospective single-institution analysis of a case series of 1,093 microlaryngoscopies performed in 661 patients between January 1994 and January 2004. Data were collected from two separate prospective databases. Feasibility and complications encountered with each technique of ventilation were analyzed as main outcome measures. RESULTS: During 1,093 suspension microlaryngoscopies, ventilation was supplied by mechanical controlled ventilation via small endotracheal tubes (n = 200), intermittent apneic ventilation (n = 159), transtracheal jet ventilation (n = 265), or transglottal jet ventilation (n = 469). Twenty-nine minor and 4 major complications occurred. Seventy-five percent of the patients with major events had an American Society of Anesthesiologists physical status classification of III. Five laryngospasms were observed with apneic intermittent ventilation. All other 24 complications (including 7 barotrauma) occurred during jet ventilation. Transtracheal jet ventilation was associated with a significantly higher complication rate than transglottal jet ventilation (P < 0.0001; odds ratio, 4.3 [95% confidence interval, 1.9-10.0]). All severe complications were related to barotraumas resulting from airway outflow obstruction during jet ventilation, most often laryngospasms. CONCLUSIONS: The use of a transtracheal cannula was the major independent risk factor for complications during jet ventilation for interventional microlaryngoscopy. The anesthetist's vigilance in clinically detecting and preventing outflow airway obstruction remains the best prevention of barotrauma during subglottic jet ventilation.
Mots-clé
Adolescent, Adult, Anesthesia, Inhalation, Child, Child, Preschool, Databases, Factual, Female, High-Frequency Jet Ventilation, Humans, Infant, Intermittent Positive-Pressure Ventilation, Intraoperative Complications, Laryngeal Diseases, Laryngoscopy, Larynx, Male, Respiration, Artificial, Retrospective Studies, Risk Factors
Pubmed
Web of science
Création de la notice
17/01/2008 17:19
Dernière modification de la notice
20/08/2019 17:11
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