Abu-Ghanem Sara, Cochran James
Department of Otolaryngology, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA.
Division of Otolaryngology, Maimonides Medical Center, Brooklyn, New York, USA.
Case Rep Anesthesiol. 2023 Sep 4;2023:5516988. doi: 10.1155/2023/5516988. eCollection 2023.
Surgical fires are known, preventable, and devastating complications of transoral microlaryngeal laser surgery. Several guidelines have recommended maintaining the fraction of inspired oxygen concentration (FiO) at or below 30% for open delivery cases. We hereby present our experience utilizing an air/oxygen gas mixing device (blender) attached to a supraglottic manual jet ventilator during transoral laser microlaryngeal surgery in three cases to control oxygen levels.
Retrospective chart review of three cases and literature review.
Three patients underwent microlaryngeal laser surgery and balloon dilation for the management of subglottic stenosis. All three patients were successfully ventilated throughout the procedures, and no major complications occurred intraoperatively. Two of three patients demonstrated symptomatic and clinical improvement at the first follow-up.
This report demonstrates the successful use of an oxygen/air blender to reduce FiO to fire-safe levels of less than 30% during laser surgery of the airway using jet ventilation.
手术火灾是经口显微喉激光手术已知的、可预防的且具有毁灭性的并发症。多项指南建议，对于开放通气的病例，应将吸入氧浓度（FiO）维持在30%或以下。在此，我们介绍三例经口激光显微喉手术中使用连接在声门上手动喷射通气器上的空气/氧气混合装置（混合器）来控制氧水平的经验。
对三例病例进行回顾性病历审查并进行文献综述。
三名患者接受了显微喉激光手术和球囊扩张术以治疗声门下狭窄。所有三名患者在整个手术过程中均成功通气，术中未发生重大并发症。三名患者中有两名在首次随访时症状和临床状况有所改善。
本报告表明，在气道激光手术中使用喷射通气时，氧气/空气混合器可成功将FiO降低至低于30%的安全防火水平。
