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首页> 外文期刊>Respiration: International Review of Thoracic Diseases >Bronchoscopic intervention obviates the need for continued mechanical ventilation in patients with airway obstruction and respiratory failure from inoperable non-small-cell lung cancer
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Bronchoscopic intervention obviates the need for continued mechanical ventilation in patients with airway obstruction and respiratory failure from inoperable non-small-cell lung cancer

机译：支气管镜干预消除了因无法手术的非小细胞肺癌而导致气道阻塞和呼吸衰竭的患者继续进行机械通气的必要性

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Background: Patients with advanced non-small-cell lung cancer (NSCLC) and acute respiratory failure (ARF) from central airway obstruction (CAO) may be offered end-of-life care rather than intensive care treatment and palliative bronchoscopic intervention. Objectives: To determine whether bronchoscopic intervention could be immediately successful in restoring airway patency and obviate the need for continued mechanical ventilation in a homogeneous group of inoperable mechanically ventilated patients with ARF and CAO from NSCLC. Methods: A retrospective study of 12 consecutive intubated and mechanically ventilated patients with inoperable or unresectable CAO from NSCLC referred for therapeutic bronchoscopic intervention between January 2003 and December 2008. Outcome measures included time-to-postintervention extubation and survival. Procedural success was defined as successful restoration of airway patency, extubation and removal from mechanical ventilation within 24 h after bronchoscopic intervention. Results: Twelve intubated and mechanically ventilated patients were admitted to the ICU during the 6-year study period. Airway patency was restored in 11/12 (91%) patients. Bronchoscopic intervention resulted in immediate extubation and discontinuation of mechanical ventilation in 9/12 (75%) patients. Overall median survival was 228 days (range 6-927). For the 9 patients extubated within 24 h after intervention, however, median survival was 313 days (range 6-927). Conclusions: Intubated patients with respiratory failure caused by CAO from NSCLC can be successfully and rapidly removed from mechanical ventilation after bronchoscopic interventions aimed at restoring airway patency. Median survival greater than 10 months justifies ICU hospitalization and referral for bronchoscopic treatment.
机译：背景：患有晚期非小细胞肺癌（NSCLC）和中枢气道阻塞（CAO）导致的急性呼吸衰竭（ARF）的患者可以接受生命终期护理，而不是重症监护和姑息性支气管镜干预。目的：确定支气管镜干预能否立即成功恢复气道通畅，并消除来自非小细胞肺癌（NSCLC）的ARF和CAO不能手术的机械通气患者的均质组的持续机械通气的需要。方法：回顾性研究2003年1月至2008年12月间，对12例来自NSCLC的不能手术或不能切除的CAO的连续气管插管和机械通气患者进行了支气管镜介入治疗。结果包括干预后拔管时间和生存率。程序上的成功定义为在支气管镜干预后24小时内成功恢复气道通畅，拔管并从机械通气中移除。结果：在为期6年的研究期内，有12名插管和机械通气患者被送入ICU。 11/12（91％）患者恢复了气道通畅。支气管镜干预导致9/12（75％）患者立即拔管并中断机械通气。总体中位生存期为228天（范围6-927）。对于介入后24小时内拔管的9例患者，中位生存期为313天（范围6-927）。结论：经支气管镜检查旨在恢复呼吸道通畅性的支气管镜干预可以成功，迅速地从机械通气中移除由NSCLC的CAO引起的气管插管呼吸衰竭患者。中位生存期超过10个月证明ICU住院并转诊接受支气管镜治疗是合理的。

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