Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Int Med Res. 2022 Aug;50(8):3000605221115163. doi: 10.1177/03000605221115163.
Endobronchial ablative therapy (EAT) in patients with preexisting obstructive airway disease can cause hypoxemia because bronchoscope insertion interferes with ventilation and a low fraction of inspired oxygen (FiO) is essential to avoid airway fire. A man in his early 50s with moderately severe obstructive airway disease was scheduled for EAT for treatment of tracheal papillomatosis. Ventilation and oxygenation would have been difficult because of narrowing of the endotracheal tube by bronchoscopic insertion and a low FiO; therefore, an i-gel supraglottic airway device with a larger inner diameter was inserted. All visible intratracheal papillomas were ablated by a potassium titanyl phosphate laser through the bronchoscopic port that passed through the lumen of the i-gel at an FiO of 0.3. During anesthesia for EAT, the i-gel supraglottic airway device provided a wider lumen for ventilation. We were thus able to provide stable ventilation at an FiO of 0.3 during EAT in this patient with obstructive airway disease, avoiding airway fire and hypoxemia.
支气管内消融治疗（EAT）在存在阻塞性气道疾病的患者中可能导致低氧血症，因为支气管镜插入会干扰通气，并且为了避免气道着火，需要低分数的吸氧（FiO2）。一位 50 多岁的男子患有中度严重的阻塞性气道疾病，计划进行 EAT 治疗气管乳头瘤病。由于支气管镜插入导致气管内管狭窄和 FiO2 低，通气和氧合将变得困难；因此，插入了一个内径更大的 i-gel 声门上气道装置。通过通过 i-gel 内腔穿过的支气管镜端口，用钛钾磷酸激光消融所有可见的气管内乳头瘤，FiO2 为 0.3。在 EAT 的麻醉期间，i-gel 声门上气道装置为通气提供了更宽的内腔。因此，我们能够在该阻塞性气道疾病患者的 EAT 期间以 FiO2 为 0.3 提供稳定的通气，避免气道着火和低氧血症。
