PhD Scientific Days 2022

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

The Use Of Laryngeal Mask Airway Reduces Postoperative Ventilatory Need In Preterm Infants Undergoing ROP Laser Treatment

Előadó neve

Dr. Trinh, Sarolta

Előadó munkahelye

I. Department of Paediatrics

Előadó telefonszáma

+36208038003

Előadó e-mail címe

trinh.sarolta@stud.semmelweis.hu

Az előadás címe

The Use Of Laryngeal Mask Airway Reduces Postoperative Ventilatory Need In Preterm Infants Undergoing ROP Laser Treatment

Szerző(k) neve és munkahelye

Sarolta Trinh1, Gyula Tövisházi2, Lóránt Kátai1, Luca Bogner1, Erika Maka3, Vera Balog1, Miklós Szabó1, Ágnes Jermendy1, Balázs Hauser2

1Division of Neonatology, 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
2Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
3Department of Ophthalmology, Semmelweis University, Budapest, Hungary

Bemutatás módja

Poszter

Szekció

Clinical Medicine V. (Poster discussion will take place in the Aula during the Coffee Break)

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: There is no protocol for anesthetic care of infants with retinopathy of prematurity undergoing laser photocoagulation (LPC). Patients can undergo sedation, topical anesthesia, or general anesthesia with endotracheal intubation (ETT). Most patients undergoing LPC have a history of difficulties with weaning from mechanical ventilation (MV), thus reintubation has a high risk for postoperative invasive ventilation (PIV). However, there is evidence that laryngeal mask airway (LMA) may provide a safe alternative.

Aims: To assess the need for PIV in preterm infants undergoing general anesthesia for retinopathy of prematurity LPC with laryngeal mask airway versus endotracheal intubation.

Method: In this retrospective cohort study premature infants undergoing LPC between 2014-2021 at the 1st Department of Pediatrics, Semmelweis University, Budapest were enrolled. Patients were allocated to Group LMA (n=224) and Group ETT (n=47) at the beginning of general anesthesia. The choice of airway management was at the discretion of the anesthesiologist. Some cases required conversion from LMA to ETT during anesthesia. Outcome was defined as need for PIV. Data is given in median [IQR], data analysis was carried out with nonparametric tests and logistic regression with a p<0.05.

Results: Patients gestational age was 26 [25;28] weeks, while birth weight was 790 [650;990] g. LPC took place on week 37 [35;39] of postmenstrual age. At the time of LPC, body weight of patients in Group LMA was significantly higher than those in Group ETT (2110 [1800;2780] g versus 1350 [1230;1610] g, p<0.0001). After the LPC 92% (n= 206) of Group LMA and 26% (n=12) of Group ETT left the operating room without any ventilatory support, while the rest of the patients required PIV. Multiple logistic regression adjusted for body weight revealed that the use of ETT significantly raised the odds of need of PIV (OR 4,80 [95%CI: 1,67-14,50]). Furthermore, a larger birth weight decreases (with every 100 g OR 0,74 [95%CI: 0,63-0,84]), while a history of longer MV support increases (with every one day spent on MV OR 1,07 [95%CI: 1,03-1,13]), and comorbidities (OR 2,02 [95%CI: 1,16-3,68]) increases the odds of PIV.

Conclusions: Data suggests that with the use of LMA the need for PIV can be reduced, independently from previous MV and body weight.

Funding: SE 250+

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Agnes Jermendy

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6843

Start

10:45

End

10:50

Authors (legacy)

Sarolta Trinh1, Gyula Tövisházi2, Lóránt Kátai1, Luca Bogner1, Erika Maka3, Vera Balog1, Miklós Szabó1, Ágnes Jermendy1, Balázs Hauser2

1Division of Neonatology, 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
2Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
3Department of Ophthalmology, Semmelweis University, Budapest, Hungary