Extubation by supraglottic airway after lobectomy prevents cough associated air leaks and prolonged coughing or sore throat.
Extubation by supraglottic airway after lobectomy prevents cough associated air leaks and prolonged coughing or sore throat.
复制标题
肺叶切除术后通过声门上气道拔管可防止咳嗽相关的漏气和长时间咳嗽或喉咙痛。
DOI：
10.1093/ejcts/ezad158
复制
发表时间：
2023
影响因子：
3.4
通讯作者：
K. Okubo
中科院分区：
文献类型：
--
作者：
H. Ishibashi;R. Wakejima;Yasuyuki Kurihara;K. Seto;S. Baba;A. Asakawa;S. Toyama;T. Uchida;K. Okubo
背景
在肺叶切除术中，双腔支气管导管对于区分肺通气是必不可少的，但它们更坚硬、更长、直径更大、更容易刺激。拔管时咳嗽有时会导致呼吸道和肺损伤，这会导致严重的漏气、长时间咳嗽和喉咙痛。我们检查了肺叶切除术后拔管时和术后咳嗽或喉咙痛的发生率，并评估了声门上呼吸道在预防这些并发症方面的效果。
方法
患者特征、手术和术后因素数据收集自2013年1月至2022年3月期间接受肺叶切除术的患者。在倾向性评分匹配后，比较声门上气道组和双腔支气管组的这些数据。
结果
1069例肺癌患者(声门上气道组641例，双腔支气管组428例)拔管时咳嗽100例(23.4%)，拔管时咳嗽伴气漏65例(65.0%)，气漏延长20例(30.8%)。声门上气道组拔管时咳嗽6例(0.9%)。在每组193名患者中，在倾向评分匹配后，声门上气道组拔管时咳嗽和相关的空气泄漏增加显著低于声门上气道组。术后第2天、第7天和第30天的术后咳嗽和喉咙痛视觉模拟评分声门上气道组显著低于对照组。
结论
声门上气道对预防肺叶切除术后咳嗽相关漏气和术后长时间咳嗽或拔管时喉咙痛是有效和安全的。
BACKGROUND
Double-lumen endobronchial tubes are essential for differential lung ventilation during pulmonary lobectomy, but they are more rigid, longer, larger in diameter, and irritable. Coughing at extubation sometimes causes airway and lung injury, which causes severe air leaks, prolonged cough, and sore throat. We examined the prevalence of cough associated air leaks at extubation and postoperative cough or sore throat after lobectomy, and evaluated the efficacy of supraglottic airway in preventing these complications.
METHODS
Patient characteristics, and operative and postoperative factors data were collected from patients who underwent pulmonary lobectomy between January 2013 and March 2022. After propensity score matching, these data were compared between the supraglottic airway and double-lumen endobronchial tubes groups.
RESULTS
1069 patients with lung cancer (supraglottic airway, 641; double-lumen endobronchial tubes, 428) were enrolled and coughing at extubation occurred in 100 (23.4%) patients in the double-lumen endobronchial tubes group, 65 (65.0%) showed increased cough associated air leaks at extubation and 20 (30.8%) showed prolonged air leaks. Coughing at extubation occurred in 6 (0.9%) in the supraglottic airway group. In 193 patients from each group after propensity score matching, coughing at extubation and the associated air leak increase were significantly lower in the supraglottic airway group. Visual analogue scale of postoperative cough and sore throat on postoperative days 2, 7, and 30 were significantly lower in the supraglottic airway group.
CONCLUSIONS
Supraglottic airway is effective and safe for preventing cough associated air leaks and prolonged postoperative cough or sore throat at extubation following pulmonary lobectomy.