Exploratory study of tracheal extubation in operating room after single-lung transplantation
10.3969/j.issn.1674-7445.2022.02.014
- VernacularTitle:单肺移植术后手术室内气管拔管方案的探索性研究
- Author:
Yanran ZHOU
1
;
Qinglong DONG
;
Hanyu YANG
;
Hui LIU
;
Lei CHEN
;
Yingfen LI
;
Lei WU
;
Xin XU
;
Chao YANG
;
Guilin PENG
;
Mengyang LIU
;
Lixia LIANG
Author Information
1. Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China
- Publication Type:Research Article
- Keywords:
Lung transplantation;
Chronic obstructive pulmonary disease;
Anesthesia management;
Enhanced recovery after surgery;
Tracheal extubation;
Mechanical ventilation;
Operating room;
Intensive care unit;
Oxygenation index;
Extracorporeal membrane oxygenation
- From:
Organ Transplantation
2022;13(2):246-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.
