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成人肺切除术中使用威伐光视双腔管与传统双腔管插管的比较:一项回顾性分析。

Intubation with vivasight double-lumen tube versus conventional double-lumen tube in adult patients undergoing lung resection: A retrospective analysis.

机构信息

Department of Anesthesia, Critical Care and Pain Medicine, University General Hospital Consortium of Valencia; University of Valencia, Spain.

Department of Anesthesia, Critical Care and Pain Medicine, Città della Salute e della Scienza, Torino, Italy.

出版信息

Ann Card Anaesth. 2022 Jul-Sep;25(3):279-285. doi: 10.4103/aca.aca_43_21.

Abstract

OBJECTIVES

The present study was designed to compare outcomes in patients undergoing thoracic surgery using the VivaSight double-lumen tube (VDLT) or the conventional double-lumen tube (cDLT).

DESIGN

A retrospective analysis of 100 patients scheduled for lung resection recruited over 21 consecutive months (January 2018-September 2019).

SETTING

Single-center university teaching hospital investigation.

PARTICIPANTS

A randomized sample of 100 patients who underwent lung resection during this period were selected for the purpose to compare 50 patients in the VDLT group and 50 in the cDLT group.

INTERVENTIONS

After institutional review board approval, patients were chosen according to inclusion and exclusion criteria and we created a general database. The 100 patients have been chosen through a random process with the Microsoft Excel program (Microsoft 2018, Version 16.16.16).

MEASUREMENTS AND MAIN RESULTS

The primary endpoint of the study was to analyze the need to use fiberoptic bronchoscopy to confirm the correct positioning of VDLT or the cDLT used for lung isolation. Secondary endpoints were respiratory parameters, admission to the intensive care unit, length of hospitalization, postoperative complications, readmission, and 30-day mortality rate. The use of fiberoptic bronchoscopy was lower in the VDLT group, and the size of the tube was smaller. The intraoperative respiratory and hemodynamics parameters were optimal. There were no other preoperative, intraoperative, or postoperative differences between both groups.

CONCLUSIONS

The VDLT reduces the need for fiberoptic bronchoscopy, and it seems that a smaller size is needed. Finally, VDLT is cost-effective using disposable fiberscopes.

摘要

目的

本研究旨在比较使用 VivaSight 双腔管(VDLT)和传统双腔管(cDLT)进行胸外科手术的患者的结局。

设计

对 21 个月内(2018 年 1 月至 2019 年 9 月)计划行肺切除术的 100 例患者进行回顾性分析。

地点

单中心大学教学医院调查。

参与者

选择在此期间行肺切除术的 100 例患者的随机样本,以比较 VDLT 组的 50 例患者和 cDLT 组的 50 例患者。

干预

经机构审查委员会批准,根据纳入和排除标准选择患者,并创建了一个通用数据库。这 100 名患者是通过 Microsoft Excel 程序(Microsoft 2018,版本 16.16.16)的随机过程选择的。

测量和主要结果

研究的主要终点是分析需要使用纤维支气管镜确认用于肺隔离的 VDLT 或 cDLT 的正确定位。次要终点是呼吸参数、入住重症监护病房、住院时间、术后并发症、再入院和 30 天死亡率。VDLT 组使用纤维支气管镜的次数较低,且管腔较小。术中呼吸和血液动力学参数最佳。两组之间无其他术前、术中或术后差异。

结论

VDLT 降低了纤维支气管镜的使用需求,似乎需要更小的尺寸。最后,使用一次性纤维镜,VDLT 具有成本效益。

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本文引用的文献

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Review of difficult airway management in thoracic surgery.胸外科困难气道管理综述
Rev Esp Anestesiol Reanim (Engl Ed). 2018 Jan;65(1):31-40. doi: 10.1016/j.redar.2017.08.001. Epub 2017 Oct 5.
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