Effect of trans-nasal humidified rapid insufflation ventilatory exchange on early postoperative atelectasis in patients undergoing prolonged gastrointestinal endoscopic procedures
10.3760/cma.j.cn131073-20241223-01008
- VernacularTitle:THRIVE对长时间消化道内镜诊疗患者术后早期肺不张的影响
- Author:
Xinyi WANG
1
;
Xin LIU
;
Zi WANG
;
Siyuan SONG
;
Mingzhu MENG
;
Ju GAO
Author Information
1. 扬州大学附属苏北人民医院麻醉科，扬州 225001
- Publication Type:Journal Article
- Keywords:
Pulmonary atelectasis;
Postoperative complications;
Endoscopic mucosal resection;
Trans-nasal humidified rapid insufflation ventilatory exchange
- From:
Chinese Journal of Anesthesiology
2025;45(10):1269-1274
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) on the early postoperative atelectasis in patients undergoing prolonged non-intubated intravenous anesthesia for gastrointestinal endoscopic procedures.Methods:In this randomized double-blind controlled trial, 150 patients of either sex, aged 18-80 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ and body mass index of 18-30 kg/m 2, scheduled for endoscopic mucosal resection of multiple colorectal polyps at Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from February 18 to June 15, 2024, were divided into 2 groups ( n=75 each) using simple random allocation: THRIVE group (group T) and conventional oxygen therapy group (group C). In group T, the oxygen flow rate was 10 L/min before anesthesia induction and increased to 50 L/min after induction until the end of operation, and the inhaled oxygen concentration was 100%. Group C used conventional mask oxygen inhalation, with an oxygen flow rate of 10 L/min during anesthesia induction and maintenance. Lung ultrasonography was performed immediately before anesthesia induction and after the end of surgery, and the modified lung ultrasound score and diaphragm mobility during quiet breathing were recorded to assess the occurrence of atelectasis and diaphragmatic dysfunction. The lowest intraoperative SpO 2 value, adverse events during surgery and in the postanesthesia care unit (PACU), duration of PACU stay, adverse events within 7 days after operation, hospitalization duration, and satisfaction scores of both patients and endoscopists were recorded. Results:Compared with group C, the postoperative modified lung ultrasound score and incidence of atelectasis and diaphragmatic dysfunction were significantly decreased, the lowest intraoperative SpO 2 value was increased, the incidence of hypoxemia was decreased, the duration of PACU stay was shortened, and endoscopists′ satisfaction scores were increased ( P<0.05), and no statistically significant changes were observed in diaphragm mobility, incidence of other intraoperative adverse events, incidence of adverse events during PACU stay and within 7 days after operation, or patients′ satisfaction scores in group T ( P>0.05). Conclusions:THRIVE can reduce the risk of early postoperative atelectasis and intraoperative hypoxemia, thereby promoting postoperative recovery of patients undergoing gastrointestinal endoscopy under long-term non-intubated anesthesia.
