Blood gases and acid-base composition in reconstruction of tracheal stenosis under specialized respiratory support

Reconstructive interventions for tracheal stenosis make additional claims to anesthetic support (effective gas exchange under prolonged opening of airways). At this stage, specialized respiratory support methods are used, such as high-frequency jet ventilation (HFJV) and apneic oxygenation (ApOx). Objective. To analyze arterial blood gases when using HFJV and ApOx for reconstruction of cicatricial tracheal stenosis. Material and methods. A prospective non-randomized comparative study included 40 patients aged 18—60 years between 11/01/2022 and 09/01/2024. We distinguished 2 groups in accordance with inclusion and non-inclusion criteria, as well as depending on respiratory support: group 1 included 28 patients who underwent HFJV, group 2 consisted of 12 patients with ApOx. Arterial blood gases and lactate were analyzed at the preoxygenation stage, every 10, 20, 30 and 40 min throughout surgery and after returning to volumetric ventilation. Results. After preoxygenation, hyperoxia was noted in both groups (more severe in case of HFJV) (p=0.0000). ApOx was accompanied by more severe hypercapnia (p=0.04) and acidosis (p=0.001) compared to HFJV. When analyzing the incidence of complications, we found between-group differences for difficult tracheal intubation (p<0.0001, c2 test). Conclusion. HFJV and ApOx in tracheal resection are accompanied by violations of blood gases and acid-base composition with hypercapnia and respiratory acidosis. ApOx provides higher oxygenation compared to HFJV. It is also accompanied by more severe respiratory acidosis without significant differences in lactatemia.