Effect of left paratracheal pressure on left carotid blood flow.

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Acta Anaesthesiologica Scandinavica Pub Date : 2024-01-01 Epub Date: 2023-10-05 DOI:10.1111/aas.14328

Benjamin Javillier, Flavien Grandjean, Karim Ounas, Nicolas Gautier, Paul Meunier, Vincent Bonhomme, Eric Deflandre

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引用次数: 0

Abstract

Introduction: Gautier et al. demonstrated that a compression in the left paratracheal region (left paratracheal pressure, LPP) can be used to seal the oesophagus. However, at this level, the left common carotid artery is very close to the carotid that could be affected during the manipulation. This study aimed to assess the hemodynamic effects of LPP on the carotid blood flow.

Methods: We prospectively included 47 healthy adult volunteers. We excluded pregnant women and people with anomalies of the carotid arteries. The common and internal carotid arteries were preliminarily studied with ultrasounds to exclude atheromatous plaques or vascular malformation. A planimetry of the common and internal carotid arteries was performed. Doppler echography served to measure the peak systolic (PSV) and end-diastolic velocities (EDV) in the common and internal carotid arteries. All measurements were repeated while applying LPP.

Results: Forty-seven participants were enrolled (32 women; mean [SD] age: 42 [13] years). The mean PSV difference [95% CI] in the left common carotid artery before and after LPP at the group level was -15.30 [-31.09 to 0.48] cm s^-1 (p = .14). The mean surface difference [95% CI] in the left common carotid artery before and after LPP was 24.52 [6.11-42.92] mm² (p = .11). Similarly, the same surface at the level of the left internal carotid artery changed by -18.89 [-51.59 to 13.80] mm² after LPP (p = .58).

Conclusions: Our results suggest that LPP does not have a significant effect on carotid blood flow in individuals without a carotid pathology. However, the safety of the manoeuvre should be evaluated in patients at risk of carotid anomalies.

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左气管旁压对左颈动脉血流的影响。

引言：Gautier等人证明了左气管旁区域的压迫（左气管旁压力，LPP）可以用来密封食道。然而，在这个水平上，左颈总动脉非常靠近在操作过程中可能受到影响的颈动脉。本研究旨在评估LPP对颈动脉血流的血液动力学影响。方法：我们前瞻性地纳入了47名健康的成年志愿者。我们排除了孕妇和颈动脉异常患者。用超声对颈总动脉和颈内动脉进行初步研究，以排除动脉粥样硬化斑块或血管畸形。对颈总动脉和颈内动脉进行了面积测量。多普勒超声心动图用于测量颈总动脉和颈内动脉的收缩峰值（PSV）和舒张末期速度（EDV）。在应用LPP时重复所有测量。结果：47名参与者被纳入研究（32名女性；平均[SD]年龄：42[13]岁）。左颈总动脉在LPP前后的平均PSV差异[95%CI]为-15.30[31.09至0.48]cm s-1（p = .14）。LPP前后左颈总动脉的平均表面差异[95%CI]为24.52[6.11-42.92]mm2（p = .11）。同样，左颈内动脉水平的同一表面在LPP后变化了-18.89[51.59至13.80]mm2（p = .58）。结论：我们的研究结果表明，在没有颈动脉病变的个体中，LPP对颈动脉血流没有显著影响。然而，应对有颈动脉异常风险的患者进行操作的安全性评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Anaesthesiologica Scandinavica 医学-麻醉学

CiteScore

4.30

自引率

9.50%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.