氧气度定位指导氧气储备指数在儿科喉手术中使用高流量鼻氧气:一个随机对照试验
Haisu Li1,2, Jianxia Liu1,2, Ling Xiong1,2
1Department of Anesthesiology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, 136 Zhongshan Er Road, Yu Zhong District, Chongqing, 400014, People's Republic of China.
氧气储备指数 (ORI) 指导儿童喉手术期间的氧气调整,使用高流量鼻氧 (HFNO) 达到生理术后的PaO2水平. 这种方法确保了足够的手术内氧化,而不会影响患者的安全.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 高流量鼻氧 (HFNO) 越来越多地用于儿科手术.
- 在麻醉期间保持最佳氧化非常重要,特别是在接受喉手术的儿科患者中.
- 目前用于调节氧化的方法可能无法始终达到生理术后水平.
研究的目的:
- 评估氧气储备指数 (ORI) 指导的氧气调整在小儿喉科手术中使用HFNO是否可以达到接近生理水平的术后PaO2.
- 为了确保在使用ORI调整氧气度时保持适当的手术内氧化.
- 为了比较经手术后的PaO2,ORI引导和常规氧化组之间的吸入氧气 (FiO2) 分数和SpO2.
主要方法:
- 接受喉手术的60名儿科患者被随机分为两个组:ORI组和对照组.
- 在ORI组,每5分钟调整一次氧气度,以达到0.21.1的ORI.
- 术后的PaO2,时间加权的平均FiO2和平均SpO2进行了比较. 分析了ORI和PaO2之间的关系.
主要成果:
- 与对照组 (323.0 mmHg) 相比,ORI组的术后PAO2 (164.9 mmHg) 显著降低 (P < 0.01).与对照组相比,ORI组的PAO2 (164.9 mmHg) 显著降低 (P < 0.01).
- 平均SPO2水平在各组之间相似 (98.4%对98.8%,P=0.36),表明在手术期间氧化没有妥协.
- 确定了0.195的最佳ORI截止值,以达到150mmHg的PaO2.
结论:
- 在小儿喉科手术期间,通过HFNO以ORI为指导调整氧气度,有效地降低了术后的PaO2,使其达到生理规范.
- 这种以ORI为指导的方法可以确保适当的手术内氧化,而不会影响患者的安全.
- 在这种特定的外科 context 中,ORI 作为优化氧气管理的宝贵工具.
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