便利输管:是时候重新审视一种旧的技术,其相关的风险被新技术所缓解
Joshua B Lowe1, Michael J Yoo1, John O Patrick2
1Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.
Cureus
|September 13, 2023
概括
使用米达佐拉姆,视频喉腔镜和定位的便利输管 (FI) 在缺氧COVID-19患者中实现了100%的第一通成功. 这种方法在药物短缺期间为快速序列输管 (RSI) 提供了一个安全的替代方案.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
背景情况:
- 方便性输液管道 (FI) 使用无麻药的镇静剂,与快速序列输液管道 (RSI) 不同.
- 对于困难的呼吸道,仅用胺的输管被使用,但短缺引起了对替代FI方法的兴趣.
- 像视频喉腔镜 (VL) 这样的现代补充剂可能会提高FI的成功率.
研究的目的:
- 为了评估FI的可行性和结果在严重缺氧的COVID-19患者在胺缺乏期间.
- 用先进的输管技术评估基于米达佐拉姆的FI的疗效.
- 为了确定在生理上困难的呼吸道中进行第一通输管的安全性和成功率.
主要方法:
- 进行了29名COVID-19患者的病例系列,这些患者在输管前氧气和率低于80%.
- 患者接受了米达佐拉姆的诱导,没有麻药,使用视频辅助喉腔镜.
- 半福勒定位和双层正压预氧化被采用,以尽量减少并发症.
主要成果:
- 所有29次输入管在第一次尝试时都成功 (100%的第一次通道成功).
- 只有一个病人需要救援麻器来打开口腔.
- 没有发生周周输液停止或吸收事件.
结论:
- 使用米达佐拉姆,VL和优化定位的便利输管对于生理上困难的呼吸道是非常有效的.
- 这种方法在没有严重的周周输液并发症的情况下取得了出色的第一通成功.
- 与米达佐拉姆的FI可能是仅胺输管的可行的替代方案,需要进一步调查.
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