European Spine Journal

, Volume 26, Issue 3, pp 840–846 | Cite as

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

  • Jian-qiang Dai
  • Wei-Feng Tu
  • Qing-shui Yin
  • Hong Xia
  • Guo-dong Zheng
  • Liang-da Zhang
  • Xian-hua Huang
Original Article

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.

Keywords

TARP Cuff-leak test Fiberoptic bronchoscopy Nasoendotracheal extubation Stridor and tracheal reintubation 

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

Notes

Acknowledgments

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

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jian-qiang Dai
    • 1
    • 2
  • Wei-Feng Tu
    • 3
  • Qing-shui Yin
    • 1
    • 2
  • Hong Xia
    • 2
  • Guo-dong Zheng
    • 2
  • Liang-da Zhang
    • 2
  • Xian-hua Huang
    • 2
  1. 1.Southern Medical UniversityGuangzhouChina
  2. 2.Orthopedic Intensive Care UnitGuangzhou General Hospital of Guangzhou Military CommandGuangzhouChina
  3. 3.Department of AnesthesiologyGuangzhou General Hospital of Guangzhou Military CommandGuangzhouChina

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