Anesthetic management in a patient with severe tracheal stenosis by monitoring oxygen reserve index

通过监测氧储备指数对重度气管狭窄患者进行麻醉管理

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Abstract

BACKGROUND: General anesthesia for tracheal stenting is challenging because of difficult ventilation and accompanying hypoxia. We report the use of oxygen reserve index (ORi™) during tracheal stenting. CASE PRESENTATION: Cauterization of an intratracheal tumor and tracheal stenting was scheduled in a patient. ORi decreased from 0.3 to 0.2 after starting cauterization using a flexible bronchoscope through a tracheal tube with 28% oxygen, while SpO(2) was maintained at 100%. ORi further decreased to 0, followed by a decrease of SpO(2) < 90%, and surgery was interrupted. SpO(2) was increased shortly after increasing FiO(2) to 1.0, but ORi remained 0 when surgery was resumed; it was increased after completion of cauterization. Both ORi and SpO(2) were maintained above 0.4 and 98%, respectively, during tracheal stenting through a rigid bronchoscope under intrapulmonary percussive ventilation. CONCLUSION: ORi was useful for predicting a decrease of SpO(2) under general anesthesia for tracheal stenting.

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