Department of Anesthesiology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
Department of Thoracic Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
BMJ Open. 2024 Mar 14;14(3):e080422. doi: 10.1136/bmjopen-2023-080422.
With the growing emphasis on swift recovery, minimally invasive thoracic surgery has advanced significantly. Video-assisted thoracoscopic surgery (VATS) has seen rapid development, and the double-lumen tube (DLT) remains the most dependable method for tracheal intubation in VATS. However, hypoxaemia during DLT intubation poses a threat to the perioperative safety of thoracic surgery patients. Recently, transnasal high-flow nasal oxygen (HFNO) has shown promise in anaesthesia, particularly in handling short-duration hypoxic airway emergencies. Yet, its application in the perioperative period for patients undergoing pulmonary surgery with compromised cardiopulmonary function lacks evidence, and there are limited reliable clinical data.
A prospective, randomised, controlled, single-blind design will be employed in this study. 112 patients aged 18-60 years undergoing elective VATS-assisted pulmonary surgery will be enrolled and randomly divided into two groups: the nasal high-flow oxygen group (H group) and the traditional mask transnasal oxygen group (M group) in a 1:1 ratio. HFNO will be used during DLT intubation for the prevention of asphyxia in group H, while conventional intubation procedures will be followed by group M. Comparison will be made between the two groups in terms of minimum oxygen saturation during intubation, hypoxaemia incidence during intubation, perioperative complications and postoperative hospital days.
Approval for this study has been granted by the local ethics committee at Shenzhen Second People's Hospital. The trial results will be disseminated through peer-reviewed journals and scientific conferences.
NCT05666908.
随着对快速康复的重视，微创胸外科得到了显著发展。电视辅助胸腔镜手术（VATS）发展迅速，双腔管（DLT）仍然是 VATS 中气管插管最可靠的方法。然而，DLT 插管期间的低氧血症对胸外科患者的围手术期安全构成威胁。最近，经鼻高流量鼻氧（HFNO）在麻醉中显示出潜力，特别是在处理短时间缺氧性气道紧急情况方面。然而，其在心肺功能受损的肺手术患者围手术期的应用缺乏证据，并且可靠的临床数据有限。
本研究将采用前瞻性、随机、对照、单盲设计。将纳入 112 名年龄在 18-60 岁之间的择期接受 VATS 辅助肺手术的患者，并随机分为两组：鼻高流量氧组（H 组）和传统经鼻面罩氧组（M 组），比例为 1:1。在 H 组中，将在 DLT 插管期间使用 HFNO 预防窒息，而 M 组将遵循常规插管程序。将比较两组在插管期间最低血氧饱和度、插管期间低氧血症发生率、围手术期并发症和术后住院天数方面的差异。
本研究已获得深圳市第二人民医院当地伦理委员会的批准。试验结果将通过同行评议的期刊和科学会议进行传播。
NCT05666908。
