The Laryngoscope · 2025
Redefining Safe Practices in Airway TruBlue Laser Surgery-A Systematic Evaluation.
СтатьяНазвание 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.
Roitman Ariel, Wilson Marcus, Bowen Andrew J, Schroeder Kristopher M, Thibeault Susan L, Dailey Seth H
Аннотация
OBJECTIVES: Fire risk during laser airway surgery is well-documented, but there is limited information regarding this risk with the novel TruBlue laser. This study evaluates its safety under different experimental conditions.
METHODS: Using a cadaveric porcine larynx and lungs model, we conducted trials with laser-safe endotracheal tubes (LSETTs), high-flow ventilation (HFV), and jet ventilation. We varied distance, FiO2 levels, and laser power settings to observe the occurrence of uncontrolled fires, brief flames, and sparks.
RESULTS: LSETT trials showed no fire events. Pledget fires were the only uncontrolled fires in HFV, at 100%, 70%, and 50% FiO2. Brief flames occurred only with 4 W continuous settings at 100% FiO2. Innocuous spark ignition rates were significantly increased by increased wattage (p < 0.05). In jet ventilation trials, brief flames appeared across a wider range of FiO2 levels and settings. HFV and jet ventilation groups showed a greater frequency and earlier occurrence of sparks and brief flames, in contrast to the event-free LSETT group (p < 0.05).
CONCLUSION: Using the TruBlue laser with a fully inflated LSETT cuff positioned at least 0.3 cm below the operating area while delivering 100% oxygen was consistently safe in our trials. Uncontrolled fires occurred only when targeting a pledget under HFV, confirming extrinsic fuel as the main risk and highlighting the safety of the TruBlue laser with HFV and jet ventilation in its absence. Compared to HFV, jet ventilation trials showed a higher frequency of brief flames and sparks. A 60-s continuous application of the laser at 100% FiO2 is safe.
LEVEL OF EVIDENCE: NA.
METHODS: Using a cadaveric porcine larynx and lungs model, we conducted trials with laser-safe endotracheal tubes (LSETTs), high-flow ventilation (HFV), and jet ventilation. We varied distance, FiO2 levels, and laser power settings to observe the occurrence of uncontrolled fires, brief flames, and sparks.
RESULTS: LSETT trials showed no fire events. Pledget fires were the only uncontrolled fires in HFV, at 100%, 70%, and 50% FiO2. Brief flames occurred only with 4 W continuous settings at 100% FiO2. Innocuous spark ignition rates were significantly increased by increased wattage (p < 0.05). In jet ventilation trials, brief flames appeared across a wider range of FiO2 levels and settings. HFV and jet ventilation groups showed a greater frequency and earlier occurrence of sparks and brief flames, in contrast to the event-free LSETT group (p < 0.05).
CONCLUSION: Using the TruBlue laser with a fully inflated LSETT cuff positioned at least 0.3 cm below the operating area while delivering 100% oxygen was consistently safe in our trials. Uncontrolled fires occurred only when targeting a pledget under HFV, confirming extrinsic fuel as the main risk and highlighting the safety of the TruBlue laser with HFV and jet ventilation in its absence. Compared to HFV, jet ventilation trials showed a higher frequency of brief flames and sparks. A 60-s continuous application of the laser at 100% FiO2 is safe.
LEVEL OF EVIDENCE: NA.