Küçük Onur, Öztürk Ayperi, Yılmaz Aydın, Alagöz Ali
Department of Anesthesiology and Reanimation, Ankara Atatürk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
Department of Interventional Pulmonology, Ankara Atatürk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
BMC Pulm Med. 2025 Apr 14;25(1):180. doi: 10.1186/s12890-025-03643-8.
BACKGROUND/AIM: This study evaluated the efficacy of high-frequency jet ventilation (HFJV) using a silicone catheter in patients undergoing rigid bronchoscopy (RB).
Following necessary approval for a retrospective clinical and experimental study, the data of patients who underwent HFJV using a silicone catheter during RB under general anesthesia through interventional pulmonology (IP) between January 2024 and August 2024 were analyzed. Prior to the study, flow/thermography tests were conducted to assess the efficacy of the silicone catheter. Arterial blood gas (ABG) analysis before, during, and after anesthesia as well as patient hemodynamic and oxygen saturation (SpO) data recorded during the procedure were evaluated. Patients were observed for up to 24 h following the procedure. The procedure included the following steps: (1) HFJV application with Evone (Ventinova, Eindhoven, Netherlands) ventilator after intubation with an orotracheal silicone catheter; (2) HFJV termination and manual ventilation (MV) application in cases of hypoxia, hypercapnia, and hemodynamic instability; (3) flow-controlled ventilation (FCV) with a laryngeal mask or tracheal intubation in patients who cannot be managed with MV; and (4) close hemodynamic monitoring as well as ABG analysis during the procedure.
A total of 25 patients were included in the study. The median duration of the procedure was 35 min. In 21 (84%) patients, the procedure was successfully performed with HFJV using a silicone ventilation catheter. In these successful cases, the hemodynamic parameters and ABG values remained within normal limits throughout the procedure. The median values of arterial oxygen partial pressure (PaO), arterial carbon dioxide partial pressure (PaCO), SpO, and pH were 210 mmHg, 41.6 mmHg, 99.4%, and 7.37, respectively, when considering the worst ABG values during the procedure. Hypoxia (SpO < 90%) was detected in 4% (n = 1) of patients, while hypercarbia (PaCO ≥ 50 mmHg) was observed in 16% (n = 4). The utilization of a Y-stent was necessary in one patient (4%). One patient (4%) experienced severe bleeding during the resection process, and one (4%) patient underwent orotracheal intubation. Postoperative pulmonary complications or adverse events were not observed in any patient.
The findings of the present study demonstrated that the utilization of silicone catheters in conjunction with HFJV is both safe and efficacious for IP and RB procedures. These results suggest that HFJV with a silicone catheter may be a viable option in RB procedures.
It cannot be applicable because it is a retrospective study.
背景/目的：本研究评估了在接受硬质支气管镜检查（RB）的患者中使用硅胶导管进行高频喷射通气（HFJV）的疗效。
在获得回顾性临床和实验研究的必要批准后，分析了2024年1月至2024年8月期间在全身麻醉下通过介入肺脏学（IP）在RB期间使用硅胶导管进行HFJV的患者数据。在研究之前，进行了流量/热成像测试以评估硅胶导管的疗效。评估了麻醉前、麻醉期间和麻醉后的动脉血气（ABG）分析以及手术过程中记录的患者血流动力学和氧饱和度（SpO）数据。术后对患者观察长达24小时。手术包括以下步骤：（1）经口气管硅胶导管插管后使用Evone（Ventinova，埃因霍温，荷兰）呼吸机进行HFJV；（2）在出现低氧、高碳酸血症和血流动力学不稳定的情况下终止HFJV并应用手动通气（MV）；（3）对无法通过MV处理的患者使用喉罩或气管插管进行流量控制通气（FCV）；（4）手术过程中密切监测血流动力学以及进行ABG分析。
本研究共纳入25例患者。手术的中位持续时间为35分钟。在21例（84%）患者中，使用硅胶通气导管通过HFJV成功完成了手术。在这些成功的病例中，整个手术过程中的血流动力学参数和ABG值均保持在正常范围内。考虑手术期间最差的ABG值时，动脉血氧分压（PaO）、动脉血二氧化碳分压（PaCO）、SpO和pH的中位值分别为210 mmHg、41.6 mmHg、99.4%和7.37。4%（n = 1）的患者检测到低氧（SpO < 90%），而16%（n = 4）的患者观察到高碳酸血症（PaCO≥50 mmHg）。1例患者（4%）需要使用Y形支架。1例患者（4%）在切除过程中出现严重出血，1例（4%）患者进行了经口气管插管。没有患者观察到术后肺部并发症或不良事件。
本研究结果表明，硅胶导管与HFJV联合使用在IP和RB手术中是安全有效的。这些结果表明，使用硅胶导管的HFJV可能是RB手术中的一种可行选择。
由于这是一项回顾性研究，因此不适用。
