通过皮肤对经过刚性支气管镜检查的儿童进行二氧化碳监测:一项前性盲目观察性研究
Martina Bordini1,2,3, Julia M Olsen1,2, Jennifer M Siu4
1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|October 16, 2024
概括
超,或高二氧化碳水平,发生在100%的儿童在刚性支气管镜检查期间. 严重的高头与更长的麻醉后护理单位停留有关,突出显示需要更好的监测.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 手术监测 手术监测
背景情况:
- 对于儿科刚性支气管镜术的麻醉管理提出了挑战,特别是在持续的潮尾二氧化碳 (EtCO2) 监测方面.
- 通过皮肤进行的二氧化碳 (TcCO2) 监测提供了一个可行的替代方案,它与PaCO2和EtCO2有很强的相关性.
研究的目的:
- 为了调查在经过刚性支气管镜检查的儿科患者中超的发生率.
- 探索与高头和相关不良事件相关的因素.
主要方法:
- 对30名接受刚性支气管镜检查的儿科患者 (18岁以下) 进行前性观察性研究.
- 持续的TcCO2监测从麻醉诱导通过麻醉后护理单元 (PACU) 逗留.
- 操作室团队对TcCO2值进行了盲目监测;当TcCO2≤50mmHg时,监测停止.
主要成果:
- 在手术室 (OR) 中100%的头高 (TcCO2 > 50 mm Hg) 的发生率;在PACU中60%的发生率.
- 17%的患者在OR中经历了严重的高头 (TcCO2>90 mm Hg).
- 氧气不和是最常见的不良事件 (57%);严重的头过度与长时间的PACU停留相关.
结论:
- 超是硬性支气管镜检查期间儿童常见的情况.
- 严重的头皮增大与延长的PACU停留有关.
- 需要进一步的研究来评估TcCO2监测,以指导这些程序中的通风器支持.
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