在激光手术中控制流量通风和高流量鼻氧,用于III级下喉狭窄症患者
J Albano Polo1, P Garrido Ortega1, J J Ruiz López1
1Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, Spain.
Revista espanola de anestesiologia y reanimacion
|August 3, 2023
概括
这项研究表明,成功的激光切除和扩张用于严重的下狭窄症,使用高流量鼻氧化为长时间的无呼吸氧化. 这种技术在关键过程中保持了足够的氧化.
科学领域:
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 呼吸系统医学 呼吸系统医学
背景情况:
- 三级下狭窄症带来了重要的气道管理挑战.
- 由于潜在的点火,传统的通风方法在激光手术期间可能会带来风险.
- 在呼吸道干预期间保持足够的氧化非常重要.
研究的目的:
- 评估高流量鼻管 (HFNC) 氧化在激光切除和下喉狭窄的扩张期间无呼吸氧化的有效性.
- 评估该技术在患有严重呼吸道损伤的患者中的安全性和可行性.
主要方法:
- 一名49岁的患者患有III级小结节狭窄症 (BMI 29.4kg/m2,ASA III) 进行了激光切除和扩张.
- 通风是使用Evone通风器在流量控制模式下进行的.
- 高流量鼻管 (HFNC) 氧化被用于无呼吸氧化在内管撤回期间,达到11分钟的无呼吸时间与SpO2>70%.
主要成果:
- 该程序通过HFNC成功完成,通过长时间的无呼吸氧化.
- 氧和度 (SpO2) 在整个11分钟的呼吸暂停期间保持在70%以上.
- 潮尾二氧化碳 (EtCO2) 水平保持在60mmHg,而吸入氧气 (FIO2) 的峰值分数由于点火风险而限制在0.3.
结论:
- 高流量鼻腔管 (HFNC) 治疗是一种可行的和有效的方法,用于无呼吸氧化在内镜呼吸道手术,如激光切除和扩张.
- 这种技术可以在患有严重的小结肠狭窄症的患者中进行安全有效的呼吸道管理,并最大限度地降低与传统通风相关的风险.
- 通过HFNC可以安全地实现长时间的无呼吸氧化,保持适当的气体交换.
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