在深度镇静下接受灵活支气管镜检查的患者中,以最大限度地减少缺氧的Supraglottic喷气氧化和通风:一个三臂随机对照试验
Juan Wei1, Xiaowei Zhang1,2, Keting Min1,3
1From the Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.
Anesthesia and analgesia
|October 24, 2023
概括
通过韦鼻喷气管 (WNJ) 进行超管喷气氧化和通风 (SJOV) 与标准的氧气输送方法相比,在深度镇静下柔性支气管 (FB) 期间显著减少缺氧. 这种技术通过尽量减少氧气脱事件来提高患者的安全性.
科学领域:
- 麻醉学和呼吸系统医学
- 干预性肺病学 干预性肺病学
- 关键护理医学 关键护理医学
背景情况:
- 在深度镇静下进行灵活支气管镜术 (FB) 的患者通常会由于低通风而出现缺氧.
- 之前的研究表明,通过鼻喷气管 (WNJ) 进行鼻喷气氧化和通风 (SJOV) 可以在FB期间减轻缺氧.
研究的目的:
- 为了比较SJOV通过WNJ在深度镇静下FB期间降低低氧发生率的有效性.
- 通过WNJ评估SJOV与通过单独WNJ或鼻腔导管 (NC) 补充氧气相比.
主要方法:
- 一个单中心,三臂随机受控试验 (RCT) 涉及成年患者接受FB.
- 患者被随机分配,通过鼻腔导管 (NC),低压低流量WNJ (LPLF) 或通过WNJ接受氧气.
- 主要结局:缺氧 (SpO2 <90%>5秒);次要结局包括呼吸抑制和不良事件.
主要成果:
- 与NC (86%) 和LPLF (61%) 相比,SJOV (9.1%) 的缺氧发生率明显较低.
- 随着SJOV (39%) 与NC (100%) 和LPLF (96%) 相比,亚临床呼吸抑制明显减少.
- 没有严重的缺氧发生在SJOV;NC需要更多的干预缺氧. Xerostomia 在SJOV中更频繁.
结论:
- 通过WNJ输送的SJOV是一种有效的方法,可以在深度镇静下灵活支气管镜检查期间减少缺氧.
- 在这种患者群体中,SJOV比传统的氧化方法显著提高了安全性.
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