Apnoeic oxygenation with high flow nasal oxygen for interventional surgery of the larynx and pharynx.
Apnoeic ventilation
HFNO
Highflow oxygenation
Larynx surgery
THRIVE
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
16 May 2024
16 May 2024
Historique:
received:
04
02
2024
accepted:
06
05
2024
medline:
16
5
2024
pubmed:
16
5
2024
entrez:
15
5
2024
Statut:
aheadofprint
Résumé
Highflow nasal cannula oxygen (HFNO) is known to be used for noninvasive oxygenation in intensive care patients but it has rarely been used in airway management for elective surgery of the upper aerodigestive tract. HFNO offers opportunities of a tubeless oxygenation system which is easy to handle and not limited only on surgery of the endolarynx. We evaluated this method for oxygenation during brief interventional procedures of the larynx and pharynx in 92 adult patients for safety and intraoperative complications. The need of secondary endotracheal intubation and limiting comorbidities as pulmonal and cardiac diseases were documented. HFNO showed a good safety profile concerning saturation and hypercapnia. Oxygen desaturation below 90% occurred only in 5 patients, mask ventilation led to quick recovery except in one patient who was secondary intubated. A significant influence of the body mass index on the minimal O2 saturation was shown (p < 0,001) so that a possible limitation of the method exists here. Comorbidities were grouped into the ASA classification. There was a significant difference between ASA I/II and ASA III patients in terms of minimum O2saturation. We conclude that HFNO may hold great promise for changing ventilator technique in general anesthesia, particularly in short elective laryngeal and pharyngeal surgery. Safety and feasibility were proven in this study.
Sections du résumé
BACKGROUND
BACKGROUND
Highflow nasal cannula oxygen (HFNO) is known to be used for noninvasive oxygenation in intensive care patients but it has rarely been used in airway management for elective surgery of the upper aerodigestive tract.
OBJECTIVES
OBJECTIVE
HFNO offers opportunities of a tubeless oxygenation system which is easy to handle and not limited only on surgery of the endolarynx.
METHODS
METHODS
We evaluated this method for oxygenation during brief interventional procedures of the larynx and pharynx in 92 adult patients for safety and intraoperative complications. The need of secondary endotracheal intubation and limiting comorbidities as pulmonal and cardiac diseases were documented.
RESULTS
RESULTS
HFNO showed a good safety profile concerning saturation and hypercapnia. Oxygen desaturation below 90% occurred only in 5 patients, mask ventilation led to quick recovery except in one patient who was secondary intubated. A significant influence of the body mass index on the minimal O2 saturation was shown (p < 0,001) so that a possible limitation of the method exists here. Comorbidities were grouped into the ASA classification. There was a significant difference between ASA I/II and ASA III patients in terms of minimum O2saturation.
CONCLUSION
CONCLUSIONS
We conclude that HFNO may hold great promise for changing ventilator technique in general anesthesia, particularly in short elective laryngeal and pharyngeal surgery. Safety and feasibility were proven in this study.
Identifiants
pubmed: 38750174
doi: 10.1007/s00405-024-08726-6
pii: 10.1007/s00405-024-08726-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Ward JJ (2013) High-flow oxygen administration by nasal cannula for adult and perinatal patients. Respir Care 58:98–122. https://doi.org/10.4187/respcare.01941
doi: 10.4187/respcare.01941
pubmed: 23271822
Helviz Y, Einav S (2018) A systematic review of the high-flow nasal cannula for adult patients. Crit Care 22:71. https://doi.org/10.1186/s13054-018-1990-4
doi: 10.1186/s13054-018-1990-4
pubmed: 29558988
pmcid: 5861611
Groves N, Tobin A (2007) High flow nasal oxygen generates positive airway pressure in adult volunteers. Aust Crit Care 20:126–31. https://doi.org/10.1016/j.aucc.2007.08.001
doi: 10.1016/j.aucc.2007.08.001
pubmed: 17931878
Frizzola M, Miller TL, Rodriguez ME, Zhu Y, Rojas J, Hesek A, Stump A, Shaffer TH, Dysart K (2011) High-flow nasal cannula: impact on oxygenation and ventilation in an acute lung injury model. Pediatr Pulmonol 46:67–74. https://doi.org/10.1002/ppul.21326
doi: 10.1002/ppul.21326
pubmed: 21171186
Frat JP, Thille AW, Mercat A, Girault C, Ragot S, Perbet S, Prat G, Boulain T, Morawiec E, Cottereau A, Devaquet J, Nseir S, Razazi K, Mira JP, Argaud L, Chakarian JC, Ricard JD, Wittebole X, Chevalier S, Herbland A, Fartoukh M, Constantin JM, Tonnelier JM, Pierrot M, Mathonnet A, Béduneau G, Delétage-Métreau C, Richard JC, Brochard L, Robert R, FLORALI Study Group, REVA Network (2015) High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med 372:2185–96. https://doi.org/10.1056/NEJMoa1503326
doi: 10.1056/NEJMoa1503326
pubmed: 25981908
Roca O, Pérez-Terán P, Masclans JR, Pérez L, Galve E, Evangelista A, Rello J (2013) Patients with New York heart association class III heart failure may benefit with high flow nasal cannula supportive therapy: high flow nasal cannula in heart failure. J Crit Care 28:741–746. https://doi.org/10.1016/j.jcrc.2013.02.007
doi: 10.1016/j.jcrc.2013.02.007
pubmed: 23602035
Stéphan F, Barrucand B, Petit P, Rézaiguia-Delclaux S, Médard A, Delannoy B, Cosserant B, Flicoteaux G, Imbert A, Pilorge C, Bérard L, BiPOP Study Group (2015) High-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after cardiothoracic surgery: a randomized clinical trial. JAMA 313:2331–9. https://doi.org/10.1001/jama.2015.5213
doi: 10.1001/jama.2015.5213
pubmed: 25980660
Lucangelo U, Vassallo FG, Marras E, Ferluga M, Beziza E, Comuzzi L, Berlot G, Zin WA (2012) High-flow nasal interface improves oxygenation in patients undergoing bronchoscopy. Crit Care Res Pract 2012:506382. https://doi.org/10.1155/2012/506382
doi: 10.1155/2012/506382
pubmed: 22666567
pmcid: 3362832
Jaber S, Monnin M, Girard M, Conseil M, Cisse M, Carr J, Mahul M, Delay JM, Belafia F, Chanques G, Molinari N, De Jong A (2016) Apnoeic oxygenation via high-flow nasal cannula oxygen combined with non-invasive ventilation preoxygenation for intubation in hypoxaemic patients in the intensive care unit: the single-centre, blinded, randomised controlled OPTINIV trial. Intensive Care Med 42:1877–1887. https://doi.org/10.1007/s00134-016-4588-9
doi: 10.1007/s00134-016-4588-9
pubmed: 27730283
Booth AWG, Vidhani K, Lee PK, Coman SH, Pelecanos AM, Dimeski G, Sturgess DJ (2021) The effect of high-flow nasal oxygen on carbon dioxide accumulation in apneic or spontaneously breathing adults during airway surgery: a randomized-controlled trial. Anesth Analg 133:133–141. https://doi.org/10.1213/ANE.0000000000005002
doi: 10.1213/ANE.0000000000005002
pubmed: 32618626
Saad M, Albi-Feldzer A, Taouachi R, Wagner I, Fischler M, Squara P, Le Guen M (2022) High-flow nasal oxygen for suspension laryngoscopy: a multicenter open-label study. J Int Med Res 50:3000605221140685. https://doi.org/10.1177/03000605221140685
doi: 10.1177/03000605221140685
pubmed: 36524243
Jaquet Y, Monnier P, Van Melle G, Ravussin P, Spahn DR, Chollet-Rivier M (2006) Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review. Anesthesiology 104(1):52–59. https://doi.org/10.1097/00000542-200601000-00010
doi: 10.1097/00000542-200601000-00010
pubmed: 16394690
Lanzenberger-Schragl E, Donner A, Grasl MC, Zimpfer M, Aloy A (2000) Superimposed high-frequency jet ventilation for laryngeal and tracheal surgery. Archiv Otolaryngol Head Neck Surg 126(1):40–44. https://doi.org/10.1001/archotol.126.1.40
doi: 10.1001/archotol.126.1.40
Shikowitz MJ, Abramson AL, Liberatore L (1991) Endolaryngeal jet ventilation: a 10-year review. Laryngoscope 101(5):455–461. https://doi.org/10.1288/00005537-199105000-00001
doi: 10.1288/00005537-199105000-00001
pubmed: 2030623
Chan KC, Yang TX, Khu KF, So CV (2023) High-flow nasal cannula versus conventional ventilation in laryngeal surgery: a systematic review and meta-analysis. Cureus 15(5):e38611. https://doi.org/10.7759/cureus.38611
doi: 10.7759/cureus.38611
pubmed: 37284366
pmcid: 10239706
Bourgain JL, Desruennes E, Fischler M, Ravussin P (2001) Transtracheal high frequency jet ventilation for endoscopic airway surgery: a multicentre study. Br J Anaesth 87(6):870–875. https://doi.org/10.1093/bja/87.6.870
doi: 10.1093/bja/87.6.870
pubmed: 11878689
Altun D, Çamcı E, Orhan-Sungur M, Sivrikoz N, Başaran B, Özkan-Seyhan T (2018) High frequency jet ventilation during endolaryngeal surgery: risk factors for complications. Auris Nasus Larynx 45(5):1047–1052. https://doi.org/10.1016/j.anl.2017.12.003
doi: 10.1016/j.anl.2017.12.003
pubmed: 29373164
Huh G, Min S, Cho SD, Cho YJ, Kwon SK (2022) Application and efficiency of transnasal humidified rapid-insufflation ventilatory exchange in laryngeal microsurgery. Laryngoscope 132(5):1061–1068. https://doi.org/10.1002/lary.29848
doi: 10.1002/lary.29848
pubmed: 34495557
Rodney JP, Shinn JR, Amin SN, Portney DS, Mitchell MB, Chopra Z, Rees AB, Kupfer RA, Hogikyan ND, Casper KA, Tate A, Vinson KN, Fletcher KC, Gelbard A, St Jacques PJ, Higgins MS, Morrison RJ, Garrett CG (2021) Multi-institutional analysis of outcomes in supraglottic jet ventilation with a team-based approach. Laryngoscope 131(10):2292–2297. https://doi.org/10.1002/lary.29431
doi: 10.1002/lary.29431
pubmed: 33609043
Lyons C, Callaghan M (2020) The use of high-flow nasal oxygen in COVID-19. Anaesthesia 75:843–847. https://doi.org/10.1111/anae.15073
doi: 10.1111/anae.15073
pubmed: 32246843
Patel A, Nouraei SA (2015) Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia 70:323–329. https://doi.org/10.1111/anae.12923
doi: 10.1111/anae.12923
pubmed: 25388828
Gustafsson IM, Lodenius Å, Tunelli J, Ullman J, Jonsson Fagerlund M (2017) Apnoeic oxygenation in adults under general anaesthesia using transnasal humidified rapid-insufflation ventilatory exchange (THRIVE)—a physiological study. Br J Anaesth 118:610–617. https://doi.org/10.1093/bja/aex036
doi: 10.1093/bja/aex036
pubmed: 28403407
Wong DT, Dallaire A, Singh KP, Madhusudan P, Jackson T, Singh M, Wong J, Chung F (2019) High-flow nasal oxygen improves safe apnea time in morbidly obese patients undergoing general anesthesia: a randomized controlled trial. Anesth Analg 129:1130–1136. https://doi.org/10.1213/ANE.0000000000003966
doi: 10.1213/ANE.0000000000003966
pubmed: 31584919
Ferrando C, Puig J, Serralta F, Carrizo J, Pozo N, Arocas B, Gutierrez A, Villar J, Belda FJ, Soro M (2019) High-flow nasal cannula oxygenation reduces postoperative hypoxemia in morbidly obese patients: a randomized controlled trial. Minerva Anestesiol 85:1062–1070. https://doi.org/10.23736/S0375-9393.19.13364-0
doi: 10.23736/S0375-9393.19.13364-0
pubmed: 30994312