Intraoperative high flow oxygen therapy for tubeless anaesthesia in thoracoscopic surgery

R. Mato-Bua , D. Lopez-Lopez , A. Garcia-Perez , C. Bonome
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Abstract

Tubeless anaesthesia has become widespread in videothoracoscopic surgery, even in major procedures such as lobectomies. There are several advantages in avoiding general anaesthesia and one-lung mechanical ventilation, such as faster recovery and shorter hospital stays. However, hypoxaemia and hypercapnia are the most reported causes of conversion to general anaesthesia. High Flow Oxygen Therapy (HFOT) generates flow-dependent positive end-expiratory pressure, improves oxygenation and also carbon dioxide washout by flow-dependent dead space flushing. For this reason, intraoperative HFOT may reduce the rate of conversion to general anaesthesia. We report our experience with intraoperative HFOT in a 71-year-old female with lung adenocarcinoma undergoing VATS upper left lobectomy.

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胸腔镜手术无管麻醉的术中高流量氧气疗法。
无管麻醉已广泛应用于视频胸腔镜手术,甚至是肺叶切除等大型手术。避免全身麻醉和单肺机械通气有很多好处,例如恢复更快、住院时间更短。然而,低氧血症和高碳酸血症是导致转为全身麻醉的最主要原因。高流量氧气疗法(HFOT)可产生流量依赖性呼气末正压,改善氧合,并通过流量依赖性死腔冲洗改善二氧化碳排出。因此,术中 HFOT 可以降低全身麻醉的转换率。我们报告了对一名 71 岁女性肺腺癌患者进行 VATS 左上肺叶切除术的术中 HFOT 经验。
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