CLINICAL-APPLICATION OF TRANSOROTRACHEAL TUBE TRACHEAL INSUFFLATION OF OXYGEN IN PATIENTS UNDERGOING SIMPLE VIDEO-ASSISTED THORACOSCOPIC SURGERY

Video-assisted thoracoscopic surgery (VATS) has been performed during ganglionectomy and bullectomy and usually requires a collapsed or immo bilized lung. Transtracheal insufflation of oxygen (TRIO) maintains an immobilized lung, adequate oxygenation, and partial CO2 elimination b ut has never been used for VATS. We have simplified the TRIO design wi th a catheter inserted through the lumen of the orotracheal tube in wh at we call ''transorotracheal tube TRIO'' (TRIO-TOTT) and investigated its clinical use on simple VATS. Eleven patients undergoing bullectom y for primary simple pneumothorax (PSP) were studied. During the perfo rmance of VATS, a 12-gauge suction catheter was inserted as our modifi cation and connected to the gas outlet of an anesthetic machine. The f low rate of oxygen was maintained at 10 L/min. Blood gas was collected prior to TRIO-TOTT, during TRIO-TOTT at 5, 10, 15, and 20 min, and 5 min after TRIO-TOTT. The blood gas data showed excellent oxygenation w hile the PaCO2 increased at a rate of 1.2 mm Hg/min compared to 3-4 mm Hg/min for apnea oxygenation. After 20 min, the mean +/- SEM PaO2 and PaCO2 were 428 +/- 27 and 65.0 +/- 2.6 mm Hg, respectively. We conclu de ventilation method for simple VATS.