Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

New Insight into Laryngo-Tracheal Surgery: High-Flow Oxygen Therapy to Prevent Early Complications after Surgery

Beatrice Trabalza Marinucci
* ORCID logo ,
Silvia Fiorelli
,
Alessandra Siciliani
,
Cecilia Menna
,
Matteo Tiracorrendo
,
Domenico Massullo
,
Federico Venuta
,
Erino Angelo Rendina
,
Anna Maria Ciccone
,
Antonio D'Andrilli
,
Mohsen Ibrahim
,
Giulio Maurizi
Version 1 : Received: 15 March 2024 / Approved: 18 March 2024 / Online: 18 March 2024 (10:00:04 CET)

A peer-reviewed article of this Preprint also exists.

Trabalza Marinucci, B.; Fiorelli, S.; Siciliani, A.; Menna, C.; Tiracorrendo, M.; Massullo, D.; Venuta, F.; Rendina, E.A.; Ciccone, A.M.; D’Andrilli, A.; Ibrahim, M.; Maurizi, G. New Insight into Laryngo-Tracheal Surgery: High-Flow Oxygen Therapy to Prevent Early Complications after Surgery. J. Pers. Med. 2024, 14, 456. Trabalza Marinucci, B.; Fiorelli, S.; Siciliani, A.; Menna, C.; Tiracorrendo, M.; Massullo, D.; Venuta, F.; Rendina, E.A.; Ciccone, A.M.; D’Andrilli, A.; Ibrahim, M.; Maurizi, G. New Insight into Laryngo-Tracheal Surgery: High-Flow Oxygen Therapy to Prevent Early Complications after Surgery. J. Pers. Med. 2024, 14, 456.

Abstract

Background: Early postoperative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ oedema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing the anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-Flow-Oxygen-Therapy(HFOT) is a noninvasive O2 support method providing humidification, warmed air, Positive-End-Expiratory-Pressure(AIRVO2). No data exist about HFOT use to prevent early complications after laryngo-tracheal surgery. Methods: Between Sept.2020-Sept.2022, 107 consecutive patients underwent laryngo-tracheal surgery received HFOT(Group A). Data and long-term results were compared with those of 80 patients operated between Sept.2018-Aug.2020(Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24-48 hours after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. Control group(B) presented “delayed” reintubation in 37% (p= 0.027), Intensive Care Unit admission in 67%(p=0.005) and longer hospital stay(p=0.001) compared to HFOT group(A). Minor complications rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of HFOT group, without a statistically significant difference (p=0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limit of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admission and hospital stay.

Keywords

tracheal surgery; peri-operative management; High Flow Oxygen Therapy

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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