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Cuff-leak test combined with interventional bronchoscopy benefits early extubation for patients who received tarp surgery

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Abstract

Purpose

This study explored the performance characteristics of a cuff-leak test (CLT) combined with interventional fiberoptic bronchoscopy (FBS) for evaluating whether early nasoendotracheal extubation was possible for patients who had received transoral atlantoaxial reduction plate (TARP) internal fixation surgery.

Methods

318 patients who underwent surgery were retrospectively analyzed (between January 2006 and December 2012). Extubation was performed by conventional approach (CA group, until December 2008) and improved approach (IA group, from January 2009) including CLT and an interventional FBS procedure. The extubation success within 1–3 days after surgery, incidence of postextubation stridor and tracheal reintubation were examined.

Results

More IA-treated patients experienced extubation during the first 2 days than those CA-treated, median extubation time was 3 (2, 3) days in the CA group and 2 (1, 2) days in the IA group (all P < 0.01). The incidence of stridor and reintubation was 5.69 and 0.57 % in IA and 11.98 and 4.93 % in CA, respectively (both P < 0.05). For the CLT-positive patients in the IA group that remained intubated until day 3–4, interventional FBS was applied for safe extubation and achieved 100 % success.

Conclusion

Early extubation through IA is safe and interventional FBS assists successful extubation for CLT-positive patients who underwent TARP surgery.

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Abbreviations

TARP:

Transoral atlantoaxial reduction plate

NET:

Nasoendotracheal tube

CLT:

Cuff-leak test

FBS:

Fiberoptic bronchoscopy

CA:

Conventional approach

IA:

Improved approach

SpO2 :

Oxygen saturation measured by pulse oximetry

M ± SD:

Mean ± standard deviation

SPSS:

Statistical package for the social science

χ2 :

Chi square test

C2:

The second cervical vertebral body

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Acknowledgments

This work was supported in part by grant BSW11C065 from key subjects of military medical scientific research fund of China.

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Authors and Affiliations

  1. Southern Medical University, Guangzhou, 510515, China

    Jian-qiang Dai & Qing-shui Yin

  2. Orthopedic Intensive Care Unit, Guangzhou General Hospital of Guangzhou Military Command, Liuhua Road NO 111, Guangzhou, 510010, China

    Jian-qiang Dai, Qing-shui Yin, Hong Xia, Guo-dong Zheng, Liang-da Zhang & Xian-hua Huang

  3. Department of Anesthesiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, 510010, China

    Wei-Feng Tu

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  1. Jian-qiang Dai
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Correspondence to Qing-shui Yin.

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Dai, Jq., Tu, WF., Yin, Qs. et al. Cuff-leak test combined with interventional bronchoscopy benefits early extubation for patients who received tarp surgery. Eur Spine J 26, 840–846 (2017). https://doi.org/10.1007/s00586-016-4487-3

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  • DOI: https://doi.org/10.1007/s00586-016-4487-3

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