在成年人中进行深度与清醒气管除的比较:一个随机对照试验
Michael A Lee1, Peter W Schenke2, Matthew R Faller2
1Naval Medical Center Camp Lejeune, 100 Brewster Blvd Camp Lejeune, Jacksonville, NC, 28547, USA. michael.a.lee32.mil@health.mil.
BMC anesthesiology
|July 31, 2025
概括
与深度输出管相比,醒着输出管在切除前出现的并发症更多,但在切除后出现的并发症较少. 两种方法都不是绝对更安全的,需要仔细考虑在出现和输出管后的风险.
科学领域:
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 醒着的输出管被认为是低风险患者的安全,而深层输出管通常是专为经验丰富的提供者保留的,因为感知风险.
- 有限的数据存在于成人深度与清醒脱口管的比较安全性.
研究的目的:
- 在接受选择性手术的成年患者中,比较深度与清醒气管输出管的安全性.
- 评估呼吸道和呼吸道并发症,呼吸道干预,血液动力学稳定性,突发动作和喉疼痛的严重程度.
主要方法:
- 预计将在全身麻醉下接受选择性手术的220名有良好的呼吸道的成年患者.
- 随机选择深度或清醒气管输出,使用标准化的挥发性麻醉剂方案.
- 主要结局:至少出现一个呼吸道或呼吸道并发症;次要结局:呼吸道干预,血液动力学参数,突发动作和喉疼痛.
主要成果:
- 抽出前,醒着抽出显示出更高的呼吸道/呼吸道并发症率,包括咳和低氧化.
- 输出管后,清醒的输出管与更低的并发症率,更少的呼吸道阻塞和更少的呼吸暂停事件有关.
- 醒着的输出管需要显著减少输出管后的气道干预,在任何一组中都没有报告严重的不良事件.
结论:
- 深度和清醒的输出管技术导致不同的气道和呼吸道并发症.
- 没有一种输出管的方法比另一种更安全;在出现和输出管后的风险必须权衡.
- 麻醉提供者应该考虑每个技术的独特风险,在开发输出策略时.
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