在深度镇静下纤维光学支气管镜检查期间,高流量鼻管流量对喉内压力的作用
1Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University or The First Hospital of Jiaxing, Jiaxing, Zhejiang Province, China; and Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang Province, China.
Respiratory care
|June 12, 2024
概括
在光纤支气管检查 (FOB) 期间,高流量鼻腔管 (HFNC) 治疗会增加喉内压力 (IPP),但不会显著增加反流吸收风险. 这表明HFNC是FOB程序的安全氧化方法.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 麻醉学 麻醉学
- 关键的护理关键的护理
背景情况:
- 通过高流量鼻腔管 (HFNC) 输送的流量可能会由于气道阻塞或泄漏而在到达声之前减少.
- 了解内压力 (IPP) 对于优化在纤维光学支气管透视 (FOB) 等手术期间的氧气输送至关重要.
研究的目的:
- 评估通过鼻气道的不同流速对接受FOB的患者在IPP上的影响.
- 评估IPP,流量和FOB期间反流吸入风险之间的关系.
主要方法:
- 招募了60名接受FOB治疗的患者.
- 测量IPP的流量为0-60L/分钟,使用或不使用N95口罩.
- 胃鼻交叉切口区域 (CSA) 和不良事件记录在FOB前后.
主要成果:
- 随着更高的流量和使用N95口罩 (P < .001),IPP显著增加.
- 在FOB后观察到胃鼻CSA显著增加 (P < .001),但反流吸血风险没有显著变化 (0%对6.7%,P = .13).
- 并发症的发病率包括低氧症 (8.3%),低心率 (6.7%) 和术后恶心/吐 (10%).
结论:
- 对于接受FOB的患者来说,HFNC是一种有效的氧化策略.
- 在FOB期间与HFNC增加IPP在0-60L/分钟范围内,似乎不会增加反流吸引的风险.
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