脊柱框架对一般麻醉易受感染的患者呼吸动态变化的影响 - 一项前性观察性研究
Preeti Kandasamy1, Vinayak S Pujari2, Sandya Rani D Channaiah1
1Department of Anaesthesiology, MS Ramaiah Medical College, Bengaluru, Karnataka, India.
Indian journal of anaesthesia
|August 21, 2023
概括
在手术中倾斜定位时使用脊柱框架会增加气道压力,并降低肺部服从性. 这一发现对于在接受易受手术的患者中管理呼吸机制至关重要.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 手术定位手术定位
背景情况:
- 倾斜的位置是一个常见的外科手术姿势.
- 过渡到容易会影响呼吸和血液动力学状态.
研究的目的:
- 评估在全身麻醉下躺卧的患者的峰值吸气压 (PIP),平原压 (Pplat) 和平均气道压 (MAP) 的变化.
- 为了比较这些呼吸系统参数与和没有脊柱框架.
- 为了评估血液动力学变化 (心率和血压).
主要方法:
- 进行了一项涉及64名患者的研究.
- 患者在全身麻醉下处于倾斜的位置.
- 两个组进行了比较:一个有脊柱框架 (S组) 和一个没有脊柱框架 (P组).
- 记录了呼吸压力和血液动力学数据.
主要成果:
- 转换患者容易显著增加PIP中位数 (S组:4cmH2O与P组:0.5cmH2O,P<0.001).
- 平原压力 (Pplat) 也显著增加 (S组:3.5 cmH2O与P组:1 cmH2O,P = 0.004).
- 与P组 (-2.78,P < 0.004) 相比,S组 (-5.513) 的动态肺服从性显著下降,比P组 (-2.78,P < 0.004) 更多.
结论:
- 倾斜的定位与脊柱框架导致气道压力显著增加.
- 在倾斜的位置上使用脊柱框架会导致动态肺部符合性更明显下降.
- 这些发现凸显了脊柱框架在容易手术期间对呼吸机制的影响.
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