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首页> 外文期刊>Brazilian Journal of Anesthesiology >Risk factors for intraoperative hypoxemia during monopulmonary ventilation: an observational study
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Risk factors for intraoperative hypoxemia during monopulmonary ventilation: an observational study

机译：单肺通气期间术中低氧血症的危险因素：一项观察性研究

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BackgroundLeft double-lumen endotracheal tubes have been widely used in thoracic, esophageal, vascular, and mediastinal procedures to provide lung separation. Lacking clear objective guidelines, anesthesiologists usually select appropriately sized double-lumen endotracheal tubes based on their experience with 35 and 37Fr double-lumen endotracheal tubes, which are the most commonly used. We hypothesized the patients with a left main bronchus of shorter length (<40mm) had a greater chance of experiencing desaturation during one lung ventilation, due to obstruction in the orifice of the left upper lobe with the bronchial tube.MethodsWe included 360 patients with a left double-lumen intubated between September 2014 and August 2015. The patient's age, sex, height, weight, and underlying disease were recorded along with type of surgical procedure and the desaturation episodes. In addition, the width of the trachea and the width and length of the left bronchus were measured using computed tomography.ResultPatients with a left main bronchus length of less than 40mm who underwent intubation with a left double-lumen endotracheal tubes had significantly higher incidence of desaturation (Odds Ratio (OR: 8.087)) during one-lung ventilation. Other related factors of patients identified to be at risk of developing hypoxia were diabetes mellitus (OR: 5.368), right side collapse surgery (OR: 4.933), and BMI (OR: 1.105).ConclusionsWe identified that patients with a left main bronchus length of less than 40mm have a great chance of desaturation, especially if other desaturation risk factors are present.
机译：背景技术左腔双腔气管导管已广泛用于胸，食道，血管和纵隔手术，以提供肺分离。由于缺乏明确的客观指南，麻醉医生通常会根据他们最常用的35和37Fr双腔气管导管的经验来选择合适尺寸的双腔气管导管。我们假设长度较短（<40mm）的左主支气管患者在一次肺通气期间由于支气管的左上叶小孔阻塞而发生去饱和的机会更大。于2014年9月至2015年8月间在左双腔静脉插管。记录患者的年龄，性别，身高，体重和基础疾病，以及手术类型和脱饱和现象。此外，使用计算机断层摄影术测量气管的宽度和左支气管的宽度和长度。一肺通气时的脱饱和度（几率（OR：8.087））。被确定有发展为低氧风险的患者的其他相关因素是糖尿病（OR：5.368），右侧塌陷手术（OR：4.933）和BMI（OR：1.105）。结论我们确定了左主支气管长度为患者小于40mm的物体有很大的脱饱和机会，尤其是在存在其他脱饱和危险因素的情况下。

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