HE Breathing Ventilation Mode Enhances Outcomes in Airway Surgery: Study Finds - Video

A study published in the Journal of Thoracic Disease underscores the benefits of the HE Breathing ventilation mode in complex airway surgeries like tracheal and carinal resection and reconstruction. These procedures, considered the pinnacle of video-assisted thoracoscopic surgery (VATS), present challenges in maintaining oxygenation and preventing hypercapnia, while ensuring optimal surgical conditions. Prof. He’s team emphasizes the importance of collaboration between surgeons and

anesthesiologists, with the choice of ventilation mode—intubated or non-intubated (tubeless)—being crucial for successful outcomes.

In a comparative study, Prof. He’s team performed thoracoscopic carinal and tracheal resections in 18 patients using the HE Breathing ventilation mode. The results showed shorter anastomosis times (22.5–40 vs. 45–86 minutes), reduced operative duration (162.5 vs. 260 minutes), and potentially shorter postoperative hospital stays (11.5±4.3 vs. 13.2±6.3 days) compared to conventional intubated ventilation.

Key advantages of the HE Breathing technique include spontaneous breathing, which reduces lung injury and infection risks while enhancing oxygenation. Although hypercapnia may occur, it improves hemodynamics and ventilation-perfusion matching. Using a laryngeal mask instead of an endotracheal tube avoids intubation-related injuries and reduces complications like throat pain and airway rupture. The absence of a tube during surgery improves visualization and precision during resection and anastomosis. Additionally, combining local anesthesia with mild intravenous sedation reduces postoperative adverse effects associated with deep anesthesia and muscle relaxants.

“We believe that with collaboration between surgeons and anesthesiologists, HE Breathing ventilation mode represents a significant advancement in airway surgery,” said Prof. He. This technique, now extended to robotic-assisted VATS, offers promising outcomes for more patients, though further research is needed to explore its full potential.

References: Zhao, Y., Liu, H., Chen, J., Xu, X., Yang, C., Peng, G., Liang, H., Jiang, L., Li, S., & He, J. (2024). HE Breathing: A new ventilation mode in airway surgery. Journal of Thoracic Disease, 16(12). https://doi.org/10.21037/jtd-24-1308