Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation : A hospital registry study from a New England healthcare network
Copyright © 2023 Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: To investigate post-procedural recovery as well as peri-procedural respiratory and hemodynamic safety parameters with prolonged use of high-frequency jet ventilation (HFJV) versus conventional ventilation in patients undergoing catheter ablation for atrial fibrillation.
DESIGN: Hospital registry study.
SETTING: Tertiary academic teaching hospital in New England.
PATIENTS: 1822 patients aged 18 years and older undergoing catheter ablation between January 2013 and June 2020.
INTERVENTIONS: HFJV versus conventional mechanical ventilation.
MEASUREMENTS: The primary outcome was post-anesthesia care unit (PACU) length of stay. In secondary analyses we assessed the effect of HFJV on intra-procedural hypoxemia, defined as the occurrence of peripheral hemoglobin oxygen saturation (SpO2) <90%, post-procedural respiratory complications (PRC) as well as intra-procedural hypocarbia and hypotension. Multivariable negative binomial and logistic regression analyses, adjusted for patient and procedural characteristics, were applied.
MAIN RESULTS: 1157 patients (63%) received HFJV for a median (interquartile range [IQR]) duration of 307 (253-360) minutes. The median (IQR) length of stay in the PACU was 244 (172-370) minutes in patients who underwent ablation with conventional mechanical ventilation and 226 (163-361) minutes in patients receiving HFJV. In adjusted analyses, patients undergoing HFJV had a longer PACU length of stay (adjusted absolute difference: 37.7 min; 95% confidence interval [CI] 9.7-65.8; p = 0.008). There was a higher risk of intra-procedural hypocarbia (adjusted odds ratio [ORadj] 5.90; 95%CI 2.63-13.23; p < 0.001) and hypotension (ORadj 1.88; 95%CI 1.31-2.72; p = 0.001) in patients undergoing HFJV. No association was found between the use of HFJV and intra-procedural hypoxemia or PRC (p = 0.51, and p = 0.97, respectively).
CONCLUSION: After confounder adjustment, HFJV for catheter ablation procedures for treatment of atrial fibrillation was associated with a longer length of stay in the PACU. It was further associated with an increased risk of intra-procedural abnormalities including abnormal carbon dioxide homeostasis, as well as intra-procedural arterial hypotension.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:93 |
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| Enthalten in: |
Journal of clinical anesthesia - 93(2024) vom: 01. März, Seite 111324 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Munoz-Acuna, Ricardo [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial Fibrillation |
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| Anmerkungen: |
Date Completed 15.01.2024 Date Revised 12.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jclinane.2023.111324 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364914734 |
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| 100 | 1 | |a Munoz-Acuna, Ricardo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Recovery and safety with prolonged high-frequency jet ventilation for catheter ablation of atrial fibrillation |b A hospital registry study from a New England healthcare network |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.01.2024 | ||
| 500 | |a Date Revised 12.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: To investigate post-procedural recovery as well as peri-procedural respiratory and hemodynamic safety parameters with prolonged use of high-frequency jet ventilation (HFJV) versus conventional ventilation in patients undergoing catheter ablation for atrial fibrillation | ||
| 520 | |a DESIGN: Hospital registry study | ||
| 520 | |a SETTING: Tertiary academic teaching hospital in New England | ||
| 520 | |a PATIENTS: 1822 patients aged 18 years and older undergoing catheter ablation between January 2013 and June 2020 | ||
| 520 | |a INTERVENTIONS: HFJV versus conventional mechanical ventilation | ||
| 520 | |a MEASUREMENTS: The primary outcome was post-anesthesia care unit (PACU) length of stay. In secondary analyses we assessed the effect of HFJV on intra-procedural hypoxemia, defined as the occurrence of peripheral hemoglobin oxygen saturation (SpO2) <90%, post-procedural respiratory complications (PRC) as well as intra-procedural hypocarbia and hypotension. Multivariable negative binomial and logistic regression analyses, adjusted for patient and procedural characteristics, were applied | ||
| 520 | |a MAIN RESULTS: 1157 patients (63%) received HFJV for a median (interquartile range [IQR]) duration of 307 (253-360) minutes. The median (IQR) length of stay in the PACU was 244 (172-370) minutes in patients who underwent ablation with conventional mechanical ventilation and 226 (163-361) minutes in patients receiving HFJV. In adjusted analyses, patients undergoing HFJV had a longer PACU length of stay (adjusted absolute difference: 37.7 min; 95% confidence interval [CI] 9.7-65.8; p = 0.008). There was a higher risk of intra-procedural hypocarbia (adjusted odds ratio [ORadj] 5.90; 95%CI 2.63-13.23; p < 0.001) and hypotension (ORadj 1.88; 95%CI 1.31-2.72; p = 0.001) in patients undergoing HFJV. No association was found between the use of HFJV and intra-procedural hypoxemia or PRC (p = 0.51, and p = 0.97, respectively) | ||
| 520 | |a CONCLUSION: After confounder adjustment, HFJV for catheter ablation procedures for treatment of atrial fibrillation was associated with a longer length of stay in the PACU. It was further associated with an increased risk of intra-procedural abnormalities including abnormal carbon dioxide homeostasis, as well as intra-procedural arterial hypotension | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Atrial Fibrillation | |
| 650 | 4 | |a Catheter Ablation | |
| 650 | 4 | |a High-Frequency Jet Ventilation | |
| 650 | 4 | |a Hypocarbia | |
| 650 | 4 | |a Hypotension | |
| 650 | 4 | |a Post-Anesthesia Care Unit | |
| 700 | 1 | |a Tartler, Tim M |e verfasserin |4 aut | |
| 700 | 1 | |a Azizi, Basit A |e verfasserin |4 aut | |
| 700 | 1 | |a Suleiman, Aiman |e verfasserin |4 aut | |
| 700 | 1 | |a Ahrens, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Wachtendorf, Luca J |e verfasserin |4 aut | |
| 700 | 1 | |a Linhardt, Felix C |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Guanqing |e verfasserin |4 aut | |
| 700 | 1 | |a Tung, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Waks, Jonathan W |e verfasserin |4 aut | |
| 700 | 1 | |a Schaefer, Maximilian S |e verfasserin |4 aut | |
| 700 | 1 | |a Sehgal, Sankalp |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:93 |g year:2024 |g day:01 |g month:03 |g pages:111324 |
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