Lung India最新文献

Abstract: Carinal resection of tumour involving trachea and carina remains as a challenge for thoracic surgeons and anaesthesiologists. Resection is technically demanding and can be associated with significant morbidity and mortality. In this case report, we describe the successful management of carinal tumour with carinal resection in a 45-year-old female. The tumour was involving lowermost trachea, carina and bilateral primary bronchi causing 60% narrowing of the lower trachea just before carina, more than 90% narrowing of right main bronchus and 50% luminal narrowing of left main bronchus. Carinal resection and reconstruction were successfully performed under general anaesthesia. Patient was managed with conventional orotracheal intubation with Micro laryngeal endotracheal tube and positioned in left principal bronchus railroaded over a paediatric bronchoscope for lung isolation. After thoracotomy, the left main bronchus was intubated directly across the operative field with a sterile flexometallic endotracheal tube. With intermittent ventilation, anastomosis was completed. During anastomosis Micro laryngeal endotracheal tube cuff was damaged twice and we had to reintubate the patient twice in lateral position itself. At the end of anastomoses, flexometallic tube was removed and wound repaired. After confirming no leakage at anastomotic site, Micro laryngeal endotracheal tube was removed and Laryngeal Mask Airway was inserted and bronchial toileting done with adult bronchoscope. Meticulous planning and communication between the anaesthesia and surgical teams are mandatory for the safe and successful anaesthetic management of carinal resection surgeries.

Objectives: The primary objective was to determine normative values of oxygen saturation (SpO2) by pulse oximetry in apparently healthy children, aged 1 month to 14 years. The secondary objective was to explore any variation in oxygen saturation levels by age and gender.

Materials and methods: It was a cross-sectional study conducted at a tertiary care centre and schools in Bhubaneswar, Odisha, India, from January 2021 to December 2022. Apparently healthy children were enrolled. Using a standardized pulse oximeter and appropriately sized probes, SpO2 was recorded after stabilization of plethysmograph waves. Three consecutive readings were taken, and an average was noted. The 2.5th centile SpO2 value was taken as the lower limit of normal.

Results: The median (IQR) saturation of the sample population was 99.7% (99-100). The 2.5th, 5th, 25th, and 75th percentiles were 97.7%, 98%, 99%, and 100%, respectively. Median SpO2 and its percentiles were estimated for each age group. The 2.5th centile SpO2 for infantile age group was 96.4%. No significant age and gender-wise variations of SpO2 were noted.

Conclusions: The present study established normal reference range oxygen SpO2 levels in apparently healthy children from an eastern India region that is situated at 62 m (204 ft) above the sea level.

Background and objective: There is a need for simple functional test to assess treatment response in chronic pulmonary aspergillosis (CPA) in resource-constrained settings. The one-minute-sit-to-stand test (1-min-STS) is one such test. However, the minimal important difference (MID) for 1-min-STS in subjects with CPA remains unknown. Herein, we estimate the MID for 1-min-STS for CPA subjects.

Materials and methods: We retrospectively reviewed the clinical details of CPA subjects treated with oral azoles for 6 months. We included only subjects who completed the 1-min-STS test at baseline and 6 months. We used the change in VAS (visual analogue scale, for overall improvement) as an external anchor. We used the anchor and the distribution (standard deviation-based) methods to determine the MID estimates. We used the anchor-based method only if there was correlation of 0.3 with the 1-min-STS test.

Results: One hundred-eight subjects completed the 1-min-STS test at baseline and 6 months. We did not find significant correlation between the change in VAS for overall improvement (r2 = 0.024, P value = 0.809) and the 1-min-STS test. The MID for the 1-min-STS test was 2 repetitions (range, 1.5-2.8 repetitions).

Conclusion: The MID for the 1-min-STS test in subjects with CPA was 2 repetitions. Future studies using a global rating of change scale as an anchor must confirm our findings.