Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation: A hospital registry study from a New England healthcare network.
| Autor: | Munoz-Acuna R; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: rmunoz2@bidmc.harvard.edu., Tartler TM; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: timtartler@t-online.de., Azizi BA; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: basit.a.azizi@gmail.com., Suleiman A; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America; Department of Anesthesia and Intensive Care, Faculty of Medicine, The University of Jordan, Queen Rania St, Amman, Jordan, 11942, Jordan. Electronic address: asuleima@bidmc.harvard.edu., Ahrens E; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: elenaahrens01@gmail.com., Wachtendorf LJ; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: lucawachtendorf@gmail.com., Linhardt FC; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: felix@flinhardt.de., Chen G; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America. Electronic address: gchen7@bidmc.harvard.edu., Tung P; Harvard-Thorndike Electrophysiology Institute, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: ptung@bidmc.harvard.edu., Waks JW; Harvard-Thorndike Electrophysiology Institute, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: jwaks@bidmc.harvard.edu., Schaefer MS; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America; Center for Anesthesia Research Excellence (CARE), Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, Boston, MA 02215, United States of America; Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, Düsseldorf 40225, Germany. Electronic address: msschaef@bidmc.harvard.edu., Sehgal S; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States of America. Electronic address: ssehgal@bidmc.harvard.edu. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of clinical anesthesia [J Clin Anesth] 2024 May; Vol. 93, pp. 111324. Date of Electronic Publication: 2023 Nov 23. |
| DOI: | 10.1016/j.jclinane.2023.111324 |
| Abstrakt: | Study Objective: To investigate post-procedural recovery as well as peri-procedural respiratory and hemodynamic safety parameters with prolonged use of high-frequency jet ventilation (HFJV) versus conventional ventilation in patients undergoing catheter ablation for atrial fibrillation. Design: Hospital registry study. Setting: Tertiary academic teaching hospital in New England. Patients: 1822 patients aged 18 years and older undergoing catheter ablation between January 2013 and June 2020. Interventions: HFJV versus conventional mechanical ventilation. Measurements: The primary outcome was post-anesthesia care unit (PACU) length of stay. In secondary analyses we assessed the effect of HFJV on intra-procedural hypoxemia, defined as the occurrence of peripheral hemoglobin oxygen saturation (SpO Main Results: 1157 patients (63%) received HFJV for a median (interquartile range [IQR]) duration of 307 (253-360) minutes. The median (IQR) length of stay in the PACU was 244 (172-370) minutes in patients who underwent ablation with conventional mechanical ventilation and 226 (163-361) minutes in patients receiving HFJV. In adjusted analyses, patients undergoing HFJV had a longer PACU length of stay (adjusted absolute difference: 37.7 min; 95% confidence interval [CI] 9.7-65.8; p = 0.008). There was a higher risk of intra-procedural hypocarbia (adjusted odds ratio [OR Conclusion: After confounder adjustment, HFJV for catheter ablation procedures for treatment of atrial fibrillation was associated with a longer length of stay in the PACU. It was further associated with an increased risk of intra-procedural abnormalities including abnormal carbon dioxide homeostasis, as well as intra-procedural arterial hypotension. Competing Interests: Declaration of Competing Interest M.S.S. has received grants for investigator-initiated trials not related to this manuscript from Merck & Co. He has received speaker fees from Mindray Medical International Limited, and from Fisher & Paykel Healthcare. He is an Associate Editor for BMC Anesthesiology and received unrestricted funds from philanthropic donors Jeffrey and Judith Buzen. J.W.W. is on an advisory board for HearCor Solutions and has received research support not related to this study from Anumana. The funders had no role in the design and conduct of the study, the collection, management, analysis, and interpretation of the data, the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. R.MA., T.M.T., B.A.A., A.S., E.A., L.J.W., F.C.L., G.C., P.T. and S.S. have no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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