Nonintubated video-assisted thoracic surgery with high-flow oxygen therapy shorten hospital stay.


Journal

Journal of the Chinese Medical Association : JCMA
ISSN: 1728-7731
Titre abrégé: J Chin Med Assoc
Pays: Netherlands
ID NLM: 101174817

Informations de publication

Date de publication:
Oct 2020
Historique:
entrez: 3 10 2020
pubmed: 4 10 2020
medline: 16 11 2021
Statut: ppublish

Résumé

Nonintubated video-assisted thoracic surgery (VATS) is widely used due to its acceptable postoperative outcomes. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been successfully applied in cases of prolonged difficult intubation and intensive respiratory care in patients receiving VATS lobectomy. Thopaz Digital Chest Drainage System (THOPAZ) provides regulated negative pressure close to the patient's chest, optimizing drainage of the pleural and mediastinum. We explored the surgical outcomes of nonintubated VATS lung wedge resection and traditional wedge resection with a double-lumen endotracheal tube. Patients who received nonintubated VATS lung wedge resection (group A, n = 81) and traditional wedge resection with double-lumen endotracheal tube (group B, n = 79) during the period of November 2015 to April 2018 were enrolled in the study. Demographic data and operation outcomes were obtained and analyzed from review of patient medical charts. Group B had significantly longer mean induction and operative times than group A. Similarly, group B suffered greater intraoperative blood loss, longer postoperative hospital stays, and increased chest tube retention times than group A. Group A had higher partial pressure of carbon dioxide levels in both the pre-one-lung and during one-lung ventilation periods than group B. Furthermore, group A showed lower serum pH levels during one-lung ventilation period. However; group A had significantly higher partial pressure of oxygen levels during one-lung ventilation than group B, although the differences in peripheral oxygen saturation were not statistically significant. Our study demonstrated that nonintubated VATS using THRIVE and THOPAZ in lung wedge resection provides measurable benefits to patients.

Sections du résumé

BACKGROUND BACKGROUND
Nonintubated video-assisted thoracic surgery (VATS) is widely used due to its acceptable postoperative outcomes. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been successfully applied in cases of prolonged difficult intubation and intensive respiratory care in patients receiving VATS lobectomy. Thopaz Digital Chest Drainage System (THOPAZ) provides regulated negative pressure close to the patient's chest, optimizing drainage of the pleural and mediastinum. We explored the surgical outcomes of nonintubated VATS lung wedge resection and traditional wedge resection with a double-lumen endotracheal tube.
METHODS METHODS
Patients who received nonintubated VATS lung wedge resection (group A, n = 81) and traditional wedge resection with double-lumen endotracheal tube (group B, n = 79) during the period of November 2015 to April 2018 were enrolled in the study. Demographic data and operation outcomes were obtained and analyzed from review of patient medical charts.
RESULTS RESULTS
Group B had significantly longer mean induction and operative times than group A. Similarly, group B suffered greater intraoperative blood loss, longer postoperative hospital stays, and increased chest tube retention times than group A. Group A had higher partial pressure of carbon dioxide levels in both the pre-one-lung and during one-lung ventilation periods than group B. Furthermore, group A showed lower serum pH levels during one-lung ventilation period. However; group A had significantly higher partial pressure of oxygen levels during one-lung ventilation than group B, although the differences in peripheral oxygen saturation were not statistically significant.
CONCLUSION CONCLUSIONS
Our study demonstrated that nonintubated VATS using THRIVE and THOPAZ in lung wedge resection provides measurable benefits to patients.

Identifiants

pubmed: 33009243
doi: 10.1097/JCMA.0000000000000408
pii: 02118582-202010000-00013
pmc: PMC7526565
doi:

Substances chimiques

Carbon Dioxide 142M471B3J
Oxygen S88TT14065

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

943-949

Commentaires et corrections

Type : CommentIn

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Auteurs

Hui-Hsuan Ke (HH)

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Po-Kuei Hsu (PK)

Department of Surgery, Division of Thoracic Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Anesthesiology, National Yang-Ming University, Taipei, Taiwan, ROC.

Mei-Yung Tsou (MY)

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Anesthesiology, National Yang-Ming University, Taipei, Taiwan, ROC.

Chien-Kun Ting (CK)

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Anesthesiology, National Yang-Ming University, Taipei, Taiwan, ROC.

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Classifications MeSH