Journal of cardiothoracic and vascular anesthesia · 2025
Laryngeal Mask Airway versus Natural Airway for Transesophageal Echocardiography: A Retrospective Comparison of Safety and Efficacy.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mongan Paul D, Colando Sarah E, Lydon Kerry M, Hoefnagel Amie L
Аннотация
OBJECTIVE: To determine whether the laryngeal mask airway (LMA) provides superior safety compared to natural airway management during non-operating room transesophageal echocardiography (TEE), focusing on hypoxemia and other periprocedural outcomes.
DESIGN: A single-center retrospective cohort study.
SETTING: Large academic medical center; procedures conducted outside of the operating room between January 2020 and December 2023.
PARTICIPANTS: A total of 1,105 adult patients undergoing elective, nonoperative TEE procedures. Patients were stratified into 2 groups: natural airway (n = 706) and LMA (n = 399).
INTERVENTIONS: Anesthesia care using either natural airway management or an LMA during TEE procedures. The choice of technique was at the discretion of the anesthesia provider.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the incidence of hypoxemia, defined as SpO₂ <90%. Secondary outcomes included hypoxemia duration, conversion to endotracheal intubation, anesthesia duration, operative duration, postanesthesia care unit length of stay, and 30-day mortality. Baseline characteristics were similar in the 2 groups. Hypoxemia occurred in 19.0% of LMA patients versus 49.0% in the natural airway group (p < 0.001), with a number needed to treat of 3.3. The median duration of hypoxemia was shorter with LMA (1 minute v 3 minutes; p < 0.001). Fewer LMA patients required intubation (1.0% v 2.1%; p < 0.001). Thirty-day mortality was 0% in the LMA group and 1.3% in the natural airway group (p = 0.023). LMA remained independently associated with reduced hypoxemia after multivariable adjustment (adjusted odds ratio, 0.19; 95% confidence interval, 0.14-0.26; p < 0.001).
CONCLUSIONS: LMA use during TEE is associated with reduced hypoxemia, shorter recovery, and lower mortality. These findings support the potential benefits of LMA as a safer airway management strategy for TEE.
DESIGN: A single-center retrospective cohort study.
SETTING: Large academic medical center; procedures conducted outside of the operating room between January 2020 and December 2023.
PARTICIPANTS: A total of 1,105 adult patients undergoing elective, nonoperative TEE procedures. Patients were stratified into 2 groups: natural airway (n = 706) and LMA (n = 399).
INTERVENTIONS: Anesthesia care using either natural airway management or an LMA during TEE procedures. The choice of technique was at the discretion of the anesthesia provider.
MEASUREMENTS AND MAIN RESULTS: The primary outcome was the incidence of hypoxemia, defined as SpO₂ <90%. Secondary outcomes included hypoxemia duration, conversion to endotracheal intubation, anesthesia duration, operative duration, postanesthesia care unit length of stay, and 30-day mortality. Baseline characteristics were similar in the 2 groups. Hypoxemia occurred in 19.0% of LMA patients versus 49.0% in the natural airway group (p < 0.001), with a number needed to treat of 3.3. The median duration of hypoxemia was shorter with LMA (1 minute v 3 minutes; p < 0.001). Fewer LMA patients required intubation (1.0% v 2.1%; p < 0.001). Thirty-day mortality was 0% in the LMA group and 1.3% in the natural airway group (p = 0.023). LMA remained independently associated with reduced hypoxemia after multivariable adjustment (adjusted odds ratio, 0.19; 95% confidence interval, 0.14-0.26; p < 0.001).
CONCLUSIONS: LMA use during TEE is associated with reduced hypoxemia, shorter recovery, and lower mortality. These findings support the potential benefits of LMA as a safer airway management strategy for TEE.