胸腔外周阻塞对单肺通风过程中通风-透气匹配的影响:一项探索性研究
Yuxian Wang1, Yilin Wei2, Guannan Chen1
1Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Journal of clinical anesthesia
|November 6, 2024
概括
胸外围堵塞 (TEB) 与全身麻醉相结合,可能会在胸外科手术患者的单肺通风 (OLV) 期间恶化通风-透气 (V/Q) 匹配. 电阻断层扫描 (EIT) 显示TEB后的分流和非通风输液增加.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 电阻断层扫描 (EIT) 可实时监测通风和输液.
- 关于胸部外周阻塞 (TEB) 在单肺通风 (OLV) 期间对通风-透气 (V / Q) 匹配的影响的数据有限.
研究的目的:
- 为了研究TEB与全身麻醉相结合对使用EIT在OLV期间肺 perfusion 分布和V/Q匹配的影响.
- 评估TEB对进行胸部手术的患者气体交换和血液动力学参数的影响.
主要方法:
- 一个单一的,前性的,随机的临床试验,涉及30名接受胸部手术的患者.
- 患者被分配到对照组或TEB组,接受胸部外周阻塞和全身麻醉.
- 在双肺通风过程中,OLV后,并在外周注射罗皮瓦卡因或盐水后进行了EIT测量和血液气体分析.
主要成果:
- TEB导致平均动脉压显著下降,但没有显著的心率变化.
- 单肺通风 (OLV) 在两组中都降低了PaO2/FiO2;TEB进一步降低了它.
- TEB增加了分流 (血液气体和EIT),非通风输液,并减少了匹配区域,表明V/Q不匹配.
结论:
- 胸外膜阻塞 (TEB) 似乎在横向位置的单肺通风 (OLV) 过程中诱导通风-透气 (V / Q) 不匹配.
- 在OLV和TEB期间,EIT是评估肺 perfusion 和通风变化的宝贵工具.
更多相关视频
相关概念视频
Acute Respiratory Failure-II
174
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
174
Ventilatory Modes
76
Mechanical ventilators are life-saving devices that support or replace spontaneous breathing. They deliver breaths to patients through varying methods known as ventilator modes. Understanding these modes is critical for healthcare providers managing patients with respiratory failure.
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
76
Factors Affecting Pulmonary Ventilation
1.2K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
1.2K
Local Anesthetics: Clinical Application as Epidural Anesthesia
414
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
414
Pneumothorax-II
120
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
120


