- 期刊
- OpenAccess
- Ahead-of-Print
Postoperative Outcomes of Lung Separation With Double-Lumen Tubes and Bronchial Blockers
摘要
Background: The choice between a double-lumen tube (DLT) and a bronchial blocker (BB) for lung isolation remains controversial. The aim of this study was to determine if the features of these lung isolation devices affect postoperative pulmonary outcomes. Methods: We retrospectively identified claims by patients who underwent surgery under lung isolation in 2000-2012 in the Taiwan National Health Insurance Research Database. After matching for age, sex, and year of surgery, 1,898 patients were enrolled in a BB group and 5,694 in a DLT group. The risks of readmission in the first postoperative year with pulmonary complications, in-hospital death, and one-year mortality were estimated using conditional logistic regression analysis. Results: Patients in the BB group had higher risks of readmission with pulmonary infection (adjusted odds ratio [aOR], 1.46; 95% confidence interval [CI], 1.22-1.74) or respiratory failure (aOR, 1.38; 95% CI, 1.09-1.76) in the first postoperative year as well as in-hospital death (aOR, 2.03; 95% CI, 1.40-2.94) and one-year mortality (aOR, 1.94; 95% CI, 1.60-2.35) than those in the DLT group after adjustment for the types of the surgeries, hospital accreditation level, underlying comorbidity, and a potentially difficult airway. Patients in the BB group had longer median (interquartile range) stays in the intensive care unit (1 [0-4] vs. 1 [0-3] days, P ＜ 0.001) and in hospital (16 [10-26] vs. 13 [8-22] days, P ＜ 0.001). Conclusion: Patients undergoing thoracic surgery are more likely to experience postoperative pulmonary complications if a BB than a DLT is used.
延伸閱讀
- Ho, C. C., Kuo, C. P., Huang, S. T., Cherng, C. H., Yeh, C. C., Wong, C. S., & Wu, C. T. (2007). Postoperative Pulmonary Edema after Lower Thoracic Spinal Tumor Surgery-A Case Report. Acta Anaesthesiologica Taiwanica, 45(2), 127-130. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200706-45-2-127-130-a
- 隋宜珊、尹慧琤、譚美珠、巫宜楹、陳維志、劉學致（2017）。Experiences of Applying Independent Lung Ventilation in Unilateral Lung Abscess Patient。呼吸治療，16(2)，13-25。https://doi.org/10.6269/JRT.2017.16.2.02
- Lin, W. T., Cheng, K. C., Liu, H. P., Hsieh, J. R., Hong, C. L., Wu, R. S. C., & Tan, P. P. C. (1998). Alternation of One-Lung and Two-Lung Ventilations with the Same Single-Lumen Endobronchial Tube during Thoracoscopic Surgery- A Case Report. Acta Anaesthesiologica Sinica, 36(4), 229-233. https://doi.org/10.6955/AAS.199812.0229
- Yun, P. J., Wu, Z. F., Huang, T. W., & Tseng, W. C. (2022). Unilateral Negative-Pressure Pulmonary Edema Following One-Lung Ventilation for Thoracic Surgery. Asian Journal of Anesthesiology, 60(2), 83-86. https://doi.org/10.6859/aja.202206_60(2).0007
- Yun, P. J., Wu, Z. F., Huang, T. W., & Tseng, W. C. (2019). Unilateral Negative-Pressure Pulmonary Edema Following One-Lung Ventilation for Thoracic Surgery. Asian Journal of Anesthesiology, (), 1-4. https://doi.org/10.6859/aja.202204/PP.0003