Effect of use of cuffed endotracheal tubes on the occurrence of postoperative extubation-related respiratory adverse events in pediatric patients with airway hypersensitivity: a retrospective cohort study.
Kazuma Sasaki, Jun Takeshita, Sayaka Nakamura, Kazuya Tachibana
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引用次数: 0
Abstract
Purpose: Whether endotracheal tube (ETT) configuration (cuffed or uncuffed) influences the occurrence of respiratory adverse events (RAEs) in patients at risk remains largely unknown. We investigated the effects of cuffed ETTs on RAE occurrence after extubation in pediatric patients with airway hypersensitivity.
Methods: Children aged < 8 years with increased airway hypersensitivity (defined as upper airway symptoms, recent upper respiratory infection within 2 weeks, or a history of asthma) who underwent general endotracheal anesthesia with inhaled agents between January 2021 and December 2022 were included. We retrospectively examined the patients' background and intraoperative anesthesia conditions by comparing the cuffed and uncuffed ETT groups. Multiple logistic regression analysis was performed to estimate the association between ETT configuration (cuffed vs. uncuffed) and the occurrence of RAEs or respiratory interventions (laryngospasm, peripheral capillary oxygen saturation < 92%, oxygen supplementation, epinephrine inhalation, or reintubation) after extubation.
Results: Cuffed ETTs were used in 163 patients and uncuffed ETTs in 143 patients. Apart from the frequency of upper airway surgery and intraoperative fluid balance, no significant differences in background characteristics were observed between the groups. RAEs after extubation were observed in 36 (22.1%) and 28 (19.6%) patients in each cuffed and uncuffed ETT groups. After adjusting for known RAE risk factors, no difference was observed in RAEs or respiratory interventions after extubation between both groups (odds ratio, 1.14; 95% confidence interval: 0.64, 2.06).
Conclusion: In pediatric patients with airway hypersensitivity, the use of cuffed ETTs did not increase the occurrence of RAEs or respiratory interventions after extubation.
目的:气管导管(ETT)配置(带袖带或不带袖带)是否会影响高危患者呼吸道不良事件(RAE)的发生在很大程度上仍是未知数。我们研究了带袖带的 ETT 对气道过敏的儿科患者拔管后发生 RAE 的影响:方法:年龄为 5 岁的儿童:结果:163 名患者使用了带袖带 ETT,143 名患者使用了无袖带 ETT。除了上气道手术的频率和术中液体平衡外,两组患者的背景特征无明显差异。在拔管后出现 RAE 的患者中,带袖带 ETT 组有 36 人(22.1%),无袖带 ETT 组有 28 人(19.6%)。在对已知的 RAE 风险因素进行调整后,两组患者在拔管后发生 RAE 或进行呼吸干预的情况没有差异(几率比 1.14;95% 置信区间:0.64, 2.06):结论:在气道过敏的儿科患者中,使用带袖带的 ETT 不会增加 RAE 的发生率或拔管后的呼吸干预。
期刊介绍:
The Journal of Anesthesia is the official journal of the Japanese Society of Anesthesiologists. This journal publishes original articles, review articles, special articles, clinical reports, short communications, letters to the editor, and book and multimedia reviews. The editors welcome the submission of manuscripts devoted to anesthesia and related topics from any country of the world. Membership in the Society is not a prerequisite.
The Journal of Anesthesia (JA) welcomes case reports that show unique cases in perioperative medicine, intensive care, emergency medicine, and pain management.