Wootten Christopher T, Rutter Michael J, Dickson John M, Samuels Paul J
Division of Pediatric Otolaryngology, Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Paediatr Anaesth. 2009 Apr;19(4):349-57. doi: 10.1111/j.1460-9592.2009.02957.x.
To better inform the preoperative anesthesia assessment, we review the rationale of tracheal T-tubes and the maintenance they require. We then describe specific intraoperative techniques to administer inhalational agents and maintain respiration in patients with tracheal T-tubes.
Tracheal T-tubes maintain airway patency in the healing phases of laryngotracheal reconstruction or in the setting of extrinsic or intrinsic airway collapse. The T-tube comprises a superior limb, an inferior limb, and an anterior limb projecting from a tracheotomy site. Negotiating tracheal T-tubes may present significant anesthetic challenges in both elective and emergent circumstances.
The intraoperative ventilation techniques in patients with tracheal T-tubes are reviewed as well as pre and postoperative T-tube maintenance strategies.
Twelve techniques to connect anesthetic circuitry to tracheal T-tubes in different perioperative clinical scenarios are detailed.
T-tubes are a well-established method for supporting the airway in both adults and children. However, the very design of the T-tube poses unique anesthetic management issues before, during, and after the operation. Anesthetic administration and gas exchange may be effectively achieved through a variety of methods, which we describe in detail.
为了更好地指导术前麻醉评估，我们回顾了气管T形管的原理及其所需的维护措施。然后，我们描述了在使用气管T形管的患者中给予吸入性药物和维持呼吸的具体术中技术。
气管T形管在喉气管重建的愈合阶段或外在性或内在性气道塌陷的情况下可维持气道通畅。T形管由一个上肢、一个下肢和一个从气管切开部位伸出的前肢组成。在择期和急诊情况下，处理气管T形管可能会带来重大的麻醉挑战。
回顾了气管T形管患者的术中通气技术以及术前和术后T形管的维护策略。
详细介绍了在不同围手术期临床场景中将麻醉回路连接到气管T形管的12种技术。
T形管是一种在成人和儿童中都已确立的支持气道的方法。然而，T形管的设计本身在手术前、手术中和手术后都带来了独特的麻醉管理问题。通过多种我们详细描述的方法，可以有效地实现麻醉给药和气体交换。
