Journal article
To Tube, or Not to Tube: Comparing Ventilation Techniques in Microlaryngeal Surgery
The Laryngoscope, v 131(12), pp 2773-2781
01 Dec 2021
PMID: 34338303
Abstract
Objectives/Hypothesis The objective of this study was to compare ventilation techniques utilized in microlaryngeal surgery. Study Design Retrospective cohort study. Methods Two-hundred surgeries performed from May 1, 2018 to March 1, 2020 and stratified as intubated, intermittently intubated (AAIV) or apneic. Patient demographics, comorbidities, anesthetic agents, intraoperative parameters/events, and complications were studied and compared across the three groups using inferential analyses. Results Median body mass index in the AAIV group was significantly higher (33 vs. 29; P = .0117). Median oxygen nadirs were lower in AAIV cases (81% vs. 91-92%) while CO2 peak measurements were lower (33 mmHg vs. 48 mmHg) in the fully apneic cohort which were significantly shorter cases (P < .0001). CO2 peak measurements were comparable between AAIV and intubated cohorts (median 48.5 mmHg vs. 48.0 mmHg). Median apnea times were significantly prolonged by 2-5.5 minutes using nasal cannula and THRIVE/Optiflow in fully apneic cases when compared to no supplementary oxygenation (P = .0013). Systolic blood pressures following insertion of laryngoscope were higher (159.5 vs. 145 mmHg) and postoperative diastolic pressures were lower (68.5 vs. 76.5 mmHg) in fully apneic cases than intubated cases. No differences existed between frequencies of complications. Conclusions This study compares intubated, intermittently apneic, and fully apneic surgeries. No statistically significant differences were noted in comorbid conditions. While intraoperative hemodynamic fluctuations were more pronounced in the fully apneic cohort, and oxygenation distributions were lower in the AAIV cohort, no significant differences existed between events and complications. Apneic techniques are as safe and effective as traditional intubation. Level of Evidence 4 Laryngoscope, 2021
Metrics
Details
- Title
- To Tube, or Not to Tube: Comparing Ventilation Techniques in Microlaryngeal Surgery
- Creators
- Mausumi N. Syamal - Lehigh Valley Hlth Network, Div Otolaryngol Head & Neck Surg, Allentown, PA USAJill Hanisak - Lehigh Valley Hospital-PoconoJennifer Macfarlan - Lehigh Valley Hospital-PoconoBriana Ortega - University of South FloridaRobert T. Sataloff - Lankenau Institute for Medical ResearchMichael S. Benninger - Cleveland Clinic
- Publication Details
- The Laryngoscope, v 131(12), pp 2773-2781
- Publisher
- Wiley
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000680029200001
- Scopus ID
- 2-s2.0-85111935948
- Other Identifier
- 991019312375104721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Medicine, Research & Experimental
- Otorhinolaryngology