在麻醉期间使用高血压和高流量鼻氧 - 冒着无法壮成长的风险?
Gavin G Pattullo1, Martin D Culwick2, Yasmin Endlich2,3,4
1North Shore Private Hospital, St. Leonards, Sydney, Australia.
Anaesthesia and intensive care
|October 11, 2023
概括
高流量鼻氧 (HFNO) 可以在麻醉期间掩盖危险的高心血管,导致严重的不良事件,如心脏骤停. 在HFNO过程中未被识别的低通风带来了显著的风险,尽管有足够的氧化.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
- 患者安全 患者安全
背景情况:
- 高流量鼻氧 (HFNO) 在麻醉期间越来越多地用于防止动脉氧气脱.
- 然而,使用HFNO存在未被检测到的低通风和高心脏的风险,可能导致心血管或神经系统的不良影响.
研究的目的:
- 为了调查与HFNO使用相关的高心脏相关不良事件的发生率.
- 分析麻醉期间高心脏病引起的并发症报告.
主要方法:
- 我们搜索了webAIRS在线数据库的麻醉相关的不良事件.
- 确定并分析了两份报告,详细介绍了HFNO使用期间的高心脏复杂症.
- 此外,还审查了11份与HFNO无关的术后高心脏关联镇静报告.
主要成果:
- 在内镜手术中使用HFNO时发现了两例显著的高心脏率,其中没有检测到低通风.
- 一个病例导致心脏骤停,原因是高心血压加剧了肺高血压;另一个病例导致意识持续下降,需要呼吸系统支持.
- 另外11份报告将严重的高心血压与术后镇静或意识丧失联系在一起,独立于HFNO.
结论:
- 在HFNO麻醉期间未被识别和未经治疗的高心脏可以导致严重的不良后果,包括心脏骤停和长时间镇静.
- 这些发现强调了在HFNO使用过程中监测通风和二氧化碳水平的关键重要性,而不仅仅是氧化.
- 该研究强调了在各种麻醉环境中与高心脏率相关的潜在危险,强调了需要保持警的必要性.
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