Scientific Reports ( IF 3.8 ) Pub Date : 2024-04-24 , DOI: 10.1038/s41598-024-60114-6 Chao Zhou 1 , Shan Song 2 , Jianfeng Fu 1 , Xuelian Zhao 1 , Huaqin Liu 1 , Huanshuang Pei 1 , Shasha Zhang 1 , Hongbo Guo 1 , Xinxin Cui 3
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Lung isolation usually refers to the isolation of the operative from the non-operative lung without isolating the non-operative lobe(s) of the operative lung. We aimed to evaluate whether protecting the non-operative lobe of the operative lung using a double-bronchial blocker (DBB) with continuous positive airway pressure (CPAP) could reduce the incidence of postoperative pneumonia. Eighty patients were randomly divided into two groups (n = 40 each): the DBB with CPAP (Group DBB) and routine bronchial blocker (Group BB) groups. In Group DBB, a 7-Fr BB was placed in the middle bronchus of the right lung for right lung surgery and in the inferior lobar bronchus of the left lung for left lung surgery. Further, a 9-Fr BB was placed in the main bronchus of the operative lung. In Group BB, routine BB placement was performed on the main bronchus on the surgical side. The primary endpoint was the postoperative pneumonia incidence. Compared with Group BB, Group DBB had a significantly lower postoperative pneumonia incidence in the operative (27.5% vs 5%, P = 0.013) and non-operative lung (40% vs 15%) on postoperative day 1. Compared with routine BB use for thoracoscopic lobectomy, using the DBB technique to isolate the operative lobe from the non-operative lobe(s) of the operative lung and providing CPAP to the non-operative lobe(s) through a BB can reduce the incidence of postoperative pneumonia in the operative and non-operative lungs.
中文翻译:

保护手术肺的非手术肺叶可以降低胸腔镜肺叶切除术后肺炎的发生率:一项随机对照试验
肺隔离通常是指将手术肺与非手术肺隔离,而不隔离手术肺的非手术肺叶。我们的目的是评估使用双支气管阻断器(DBB)和持续气道正压通气(CPAP)保护手术肺的非手术肺叶是否可以降低术后肺炎的发生率。 80 例患者被随机分为两组(每组 40 例):DBB 联合 CPAP 组(DBB 组)和常规支气管阻滞剂组(BB 组)。在 DBB 组中,将 7-Fr BB 放置在右肺中支气管中进行右肺手术,将 7-Fr BB 放置在左肺下叶支气管中进行左肺手术。此外,将 9-Fr BB 放置在手术肺的主支气管中。在BB组中,在手术侧的主支气管上进行常规BB放置。主要终点是术后肺炎发生率。与BB组相比,DBB组术后第1天手术肺(27.5% vs 5%, P = 0.013)和非手术肺(40% vs 15%)术后肺炎发生率显着降低。对于胸腔镜肺叶切除术,使用 DBB 技术将手术肺叶与非手术肺叶隔离,并通过 BB 为非手术肺叶提供 CPAP 可以降低术后肺炎的发生率。手术肺和非手术肺。