Perioperative airway management in patients undergoing bronchoscopic treatment of tracheal stenosis / 中华麻醉学杂志

ABSTRACT

Data of patients underwent bronchoscopic treatment of tracheal stenosis from May 2011 to April 2016 were collected.Patients were questioned about the medical history before operation, and the airway was fully evaluated.The laryngeal mask was used for the patients with upper 1/3 tracheal stenosis and subglottic stenosis, and endotracheal intubation was applied for the other patients.Patients with severe tracheal stenosis received extracorporeal membrane oxygenation (ECMO)-assisted ventilation.The tracheal tube or laryngeal mask was removed immediately when patients were awake and spontaneous breathing and swallowing reflex recovered after operation, and oxygen was inhaled by mask.A total of 189 patients were included in this study, 93 patients received endotracheal intubation, and 91 patients were ventilated via the laryngeal mask, and 5 patients underwent ECMO-assisted ventilation.Forty-four patients adopted the method of preserving spontaneous breathing, and the other 145 patients did not.There were 165 patients in whom the endotracheal tube or laryngeal mask was removed immediately after they were awake, and the remaining 24 cases were sent to the intensive care unit with the endotracheal tube.For the patients with tracheal stenosis, preoperative interview and airway assessment are especially important, and appropriate airway management strategies should be developed; vital signs should be closely observed during operation, and the proper ventilation mode is selected, and ECMO-assisted ventilation could be considered for the patients with severe tracheal stenosis; the timing of removal of the endotracheal tube or laryngeal mask should be seized after operation.