Department of Pulmonary and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Clin Respir J. 2022 Oct;16(10):677-684. doi: 10.1111/crj.13539. Epub 2022 Sep 15.
Combined forceps and cryoprobe biopsy during bronchoscopy are increasingly used. However, the adult standard cuffed endotracheal tube (SCETT) is can be limited by general anaesthesia and neuromuscular blockade. An adult uncuffed endotracheal tube (UCETT) might provide simple and safe airway support in stable patients during forceps and cryoprobe biopsy under spontaneous respiration.
A retrospective review of stable patients undergoing forceps and cryoprobe biopsy was performed. They were divided into a UCETT group (N = 33) and a SCETT group (N = 27). The primary technical outcome was the successful intubation and completion of bronchoscopy. The primary safety outcome was the incidence of desaturation events. Recovery time and side effects were also recorded.
UCETTs and SCETTs were successfully inserted, and bronchoscopic procedures were completed in all patients. Only 3/33 (9.1%) patients in the UCETT group exhibited a drop of SPO < 90% during the bronchoscopy, compared to 2/27 (7.4%) patients in the SCETT group (P = 0.545). Patients recovered faster in the UCETT group than those in the SCETT group. Major bleeding, laryngospasm and major arrhythmias did not occur in either group. Incidences of sinus tachycardia, incidences of vomiting, minor and moderate bleeding and premature atrial contractions were not significantly different between the two groups. Nausea occurred in 5/33 (15.2%) patients in the UCETT group, compared to 11/27 (40.7%) in the SCETT group.
This study suggests that UCETT under spontaneous respiration can provide satisfactory airway support and a shorter recovery time in stable patients; thus, it may be an option to assist forceps and cryoprobe biopsy.
经支气管镜联合活检钳和冷冻探针的应用越来越广泛。然而，全身麻醉和神经肌肉阻滞会限制成人标准带囊气管插管（SCETT）的使用。在自主呼吸下，使用成人无囊气管插管（UCETT）可为活检钳和冷冻探针活检提供简单且安全的气道支持，适用于稳定的患者。
对行活检钳和冷冻探针检查的稳定患者进行回顾性分析。患者分为 UCETT 组（N=33）和 SCETT 组（N=27）。主要技术结局是插管成功和支气管镜检查完成。主要安全性结局是血氧饱和度（SpO2）下降事件的发生率。记录恢复时间和副作用。
所有患者均成功插入 UCETT 和 SCETT，且完成了支气管镜检查。仅 3/33（9.1%）的 UCETT 组患者在支气管镜检查过程中出现 SpO2<90%，而 SCETT 组仅 2/27（7.4%）（P=0.545）。UCETT 组患者的恢复速度快于 SCETT 组。两组均未发生大出血、喉痉挛和严重心律失常。窦性心动过速、呕吐、轻度和中度出血以及房性早搏的发生率在两组之间无显著差异。UCETT 组 5/33（15.2%）的患者出现恶心，而 SCETT 组 11/27（40.7%）（P=0.545）。
本研究表明，在稳定的患者中，自主呼吸下使用 UCETT 可提供满意的气道支持和更快的恢复时间，因此，UCETT 可能是协助活检钳和冷冻探针的一种选择。
