Volume 13 Issue 2
Mar.  2022
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Zhou Yanran, Dong Qinglong, Yang Hanyu, et al. Exploratory study of tracheal extubation in operating room after single-lung transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 246-252. doi: 10.3969/j.issn.1674-7445.2022.02.014
Citation: Zhou Yanran, Dong Qinglong, Yang Hanyu, et al. Exploratory study of tracheal extubation in operating room after single-lung transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 246-252. doi: 10.3969/j.issn.1674-7445.2022.02.014
shu

Exploratory study of tracheal extubation in operating room after single-lung transplantation

doi: 10.3969/j.issn.1674-7445.2022.02.014

  • Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China

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  • Corresponding author: Liang Lixia, Email: drllx@tom.com
  • Received Date: 2021-10-16
    Available Online: 2022-03-18
  • Publish Date: 2022-03-15
    Abstract
  •   Objective  To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation.  Methods  Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups.  Results  Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO2), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05).  Conclusions  The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.

     

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